Meniere’s disease: Symptoms, causes, and treatments

Ménière’s disease is a condition characterized by vertigo, tinnitus, and progressive deafness. There is no cure, but there are some treatments that can ease the symptoms.

According to the National Institute on Deafness and Other Communication Disorders, approximately 615,000 people in the United States have Ménière’s. The disease can develop at any age, but most commonly appears between the age of 40 and 60 years and normally only affects one ear.

Ménière’s disease is caused by a dysfunction in the inner ear. The labyrinth is a system of small fluid-filled channels that send sound and balance signals to the brain. It is an unpredictable disease that requires various types of treatment.

This MNT Knowledge Center article will look at the symptoms, causes, natural and conventional treatments, diet options for reducing symptoms, and the triggers of Ménière’s disease.

Fast facts on Ménière’s disease

Here are some key points about Ménière’s disease. More detail and supporting information is in the main article.

Ménière’s disease involves dysfunction in the inner ear.

Attacks can last an average of 2 to 4 hours.

Symptoms include vertigo, dizziness, nausea, and a progressive loss of hearing.

The exact causes of Ménière’s disease are not known.

Treatment

Although there is no cure, treatment can help manage some of the symptoms.

Lifestyle changes

There appears to be a link between smoking and tinnitus, so quitting may help to reduce symptoms and soothe the effects.

There are links between Ménière’s disease, stress, and anxiety. However, it is not known whether stress and anxiety cause symptoms or whether Ménière’s disease leads to stress and anxiety. However, some studies indicate that good stress and anxiety management can help reduce the intensity of symptoms.

Medications for vertigo

Selection of pills
Certain medications can ease the symptoms of Meniere’s.

These may include:

motion sickness drugs, such as meclizine (Antivert) or diazepam (Valium). They can help with the spinning sensation, as well as nausea and vomiting.

drugs for nausea, such Prochlorperazine is effective in the treatment of nausea during a vertigo episode.

diuretics, for example, a combination of triamterene and hydrochlorothiazide (Dyazide, Maxzide) to reduce fluid retention.

By reducing the amount of fluid the body retains, the fluid volume and pressure in the inner ear may improve, resulting in less severe and less frequent symptoms.

Middle ear injections

Some injections into the middle ear may improve symptoms of vertigo.

They include gentamicin, an antibiotic, and steroids, including dexamethasone.

Surgery

Surgery may be an option if other treatments have not worked or if symptoms are severe. Surgery options include:

endolymphatic sac decompression, in which a small portion of bone is removed from over the endolymphatic sac

labyrinthectomy, where a portion of the inner ear is surgically removed

vestibular nerve section, in which the vestibular nerve is cut

vestibular rehabilitation therapy, in which people who have problems with their balance between episodes of vertigo may benefit from exercises and activities aimed at helping the body and the brain regain the ability to process balance data properly

People with hearing loss may benefit from a hearing aid.

Symptoms

Dizzy in the woods
Vertigo is one of the most obvious symptoms of Ménière’s disease.

Symptoms vary from person to person; they can occur suddenly, and their frequency and duration differ.

They are often referred to as an “attack.” These attacks vary in length but are an average of 2 to 4 hours long.

Common symptoms that occur during an attack include:

Vertigo: This is usually the most obvious symptom of Ménières disease, which includes:

a feeling that you are spinning, even when you are not moving

dizziness

vomiting

nausea

irregular heartbeat

sweating

An episode of vertigo may last from a few minutes to a number of hours. As it is difficult to predict when a vertigo attack will occur, it is important to have vertigo medication handy at all times. Vertigo can interfere with driving, operating heavy machinery, climbing ladders/scaffolding, and swimming.

Tinnitus: This is a ringing, buzzing, roaring, whistling, or hissing in the ear. People are generally more aware of it during quiet times, or when they are tired.

Hearing loss: Hearing loss can fluctuate, especially early on in the disease. There may also be a sensitivity to loud sounds. Eventually, most people experience some degree of long-term hearing loss.

Stages

Ménière’s disease develops in three stages.

1) Early: This involves sudden and unpredictable episodes of vertigo. Episodes last from 20 minutes to 24 hours. During episodes, there will be some hearing loss, which returns to normal after it is over. The ear may feel uncomfortable and blocked, with a sense of fullness or pressure. Tinnitus is also common.

2) Middle: Vertigo episodes continue but are usually less severe. Tinnitus and hearing loss get worse. During this stage, some people will experience periods of complete remission where symptoms disappear. These periods of remission can last several months.

3) Late: Vertigo episodes become even less frequent, and in some cases never come back. Balance problems, though, can continue. Individuals will feel especially unsteady when it is dark. Hearing and tinnitus normally get steadily worse.

The following symptoms are also possible. These are known as secondary symptoms:

Anxiety, stress, depression: These can result because Ménière’s disease is unpredictable, many individuals become anxious, depressed, and stressed. The disease can have an impact on the individual’s work, especially if they have to climb ladders or operate machinery. As hearing gets progressively worse, they may find it more difficult to interact with other people.

Some people cannot drive, further limiting their independence, job prospects, freedom, and access to friends and family. It is important for people who experience stress, anxiety, and depression to tell their doctor.

Complications

The biggest problem of Ménière’s disease is not knowing when episodes of vertigo will occur. The individual may have to lie down and miss out on social, leisure, work, or family activities. People with Ménière’s also have a higher risk of falling, having accidents while driving a vehicle or operating heavy machinery, as well as developing depression or suffering from high levels of anxiety.

Vehicle licensing authorities in many countries state that if you have been diagnosed with Ménière’s disease, you must cease driving. Driving is not allowed until symptoms are under control — this will need to be confirmed by a doctor.

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