Meniere’s disease is a disorder that affects the inner ear. The inner ear is responsible for hearing and balance. The condition causes vertigo, the sensation of spinning. It also leads to hearing problems and a ringing sound in the ear. Meniere’s disease usually affects only one ear.
The National Institute on Deafness and Other Communication Disorders (NIDCD) estimates that 615,000 people in the United States have Meniere’s disease. Around 45,500 people are diagnosed each year. It’s most likely to occur in people in their 40s and 50s.
Meniere’s disease is chronic, but treatments and lifestyle changes can help ease symptoms. Many people diagnosed with Meniere’s disease will go into remission within a few years after their diagnosis.
What Causes Meniere’s disease?
The cause of Meniere's disease is unknown. Symptoms of Meniere's disease appear to be the result of an abnormal amount of fluid (endolymph) in the inner ear, but it isn't clear what causes that to happen.
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Factors that affect the fluid, which might contribute to Meniere's disease, include:
. Improper fluid drainage, perhaps because of a blockage or anatomic abnormality
. Abnormal immune response
. Viral infection
. Genetic predisposition
Because no single cause has been identified, it's likely that Meniere's disease results from a combination of factors.
What Are the Symptoms of Meniere’s Disease?
Meniere’s disease symptoms tend to come on as “episodes” or “attacks.” These symptoms include:
. vertigo, with attacks lasting anywhere from a few minutes to 24 hours
. loss of hearing in the affected ear
. tinnitus, or the sensation of ringing, in the affected ear
. aural fullness, or the feeling that the ear is full or plugged
. loss of balance
. nausea, vomiting, and sweating caused by severe vertigo
Someone with Meniere’s disease will experience at least two to three of the following symptoms at one time:
. hearing loss
. aural fullness
Most people with Meniere’s disease don’t experience symptoms between episodes. So, many of these symptoms can be caused by other problems in the ear if they occur during a period with no attacks. Meniere’s disease may also be confused for other inner ear disorders, such as labyrinthitis.
How Is Meniere’s Disease Diagnosed?
If you’re experiencing symptoms of Meniere’s disease, your doctor will order tests to examine your balance and hearing, and rule out other causes of your symptoms.
A hearing test, or audiometry, is used to determine if you’re experiencing hearing loss. In this test, you’ll put on headphones and hear noises of a variety of pitches and volumes. You’ll need to indicate when you can and cannot hear a tone, so the technician can determine if you’re experiencing hearing loss.
Your hearing will also be tested to determine if you can tell the difference between similar sounds. In this portion of the test, you’ll hear words through the headphones and repeat what you hear. The results of this test will tell your doctor if you have a hearing problem in one or both ears.
A problem in the inner ear, or with the nerve in the ear, can cause hearing loss. An electrocochleography (ECog) test is done to measure the electrical activity in the inner ear. An auditory brainstem response (ABR) test checks the function of the hearing nerves and the hearing center in the brain. These tests can tell your doctor if the problem is caused by your inner ear or with your ear nerve.
Balance tests are performed to test the function of your inner ear. People who have Meniere’s disease will have a reduced balance response in one of their ears. The balance test most commonly used to test for Meniere’s disease is electronystagmography (ENG).
In this test, you’ll have electrodes placed around your eyes to detect eye movement. This is done because the balance response in the inner ear causes eye movements. During this test, both hot and cold water will be pushed into your ear. The water causes your balance function to work. Your involuntary eye movements will be tracked. Any abnormalities can indicate a problem with the inner ear.
Rotary chair testing is used less often. It’ll show your doctor whether your problem is caused by an issue in your ear or your brain. It’s used in addition to ENG testing because the ENG results can be incorrect if you have ear damage or wax is blocking one of your ear’s canals. In this test, your eye movements are carefully recorded while the chair moves.
Vestibular evoked myogenic potential (VEMP) testing measures the sound sensitivity of the vestibule of the inner ear. And posturography testing helps determine what part of your balance system isn’t functioning properly. You’ll react to various balance challenges while wearing a safety harness and standing barefoot.
Issues with the brain, such as multiple sclerosis (MS) or brain tumors, can cause symptoms similar to Meniere’s disease. Your doctor may order tests to rule out these, and other, conditions. They may also order a head MRI or a cranial CT scan to assess possible problems with your brain.
How Is Meniere’s Disease Treated?
Meniere’s disease is a chronic condition with no cure. However, there are a range of treatments that can help with your symptoms, from medication to surgery for the most severe cases.
Your doctor may prescribe medication to help with the symptoms of Meniere’s disease. Medicines for motion sickness can ease symptoms of vertigo, nausea, and vomiting. If nausea and vomiting becomes an issue, your doctor may prescribe an antiemetic, or anti-nausea medication.
A problem with fluid in the inner ear is thought to cause Meniere’s disease. If this occurs, your doctor may prescribe a diuretic to help reduce the amount of fluid in your body. Your doctor can also inject medication into your inner ear by way of your middle ear to help reduce vertigo symptoms.
Vestibular rehabilitation exercises can improve symptoms of vertigo. These exercises help to train your brain to account for the difference in balance between your two ears. A physical therapist can teach you these exercises.
An audiologist can treat hearing loss, usually by fitting you with a hearing aid.
Most people with Meniere’s disease don’t require surgery, but it’s an option for those who have severe attacks and haven’t had success with other treatments. An endolymphatic sac procedure is done to help decrease the production of fluid and promote fluid drainage in the inner ear.
What Effect Does Diet Have on Meniere’s Disease?
Changing your diet may help to reduce the amount of fluid in the inner ear and ease symptoms. Foods and substances to limit or exclude from your diet include:
. monosodium glutamate (MSG)
It’s also important to drink six to eight glasses of water per day so your body isn’t retaining fluid. Learn more about the Meniere’s disease diet.
What Lifestyle Changes May Help the Symptoms of Meniere’s Disease?
Lifestyle changes, aside from dietary ones, that may help improve your symptoms include:
. resting during vertigo attacks
. eating regularly, to help regulate fluids in your body
. managing stress and anxiety through psychotherapy or medication
It’s also important to quit smoking and to avoid any allergens. Both nicotine and allergies can make the symptoms of Meniere’s disease worse.
What’s The Outlook for People with Meniere’s Disease?
Even though there’s no cure for Meniere’s disease, there are many strategies you might want to consider to reduce your symptoms. In most people, spontaneous remission is common, although it can take years. Your doctor can help find a treatment that’s right for you.