What is Meniere's disease?

Meniere's disease is a disorder of the inner ear that can cause vertigo and ringing in the ear. The condition usually affects only one ear. Young and middle-aged adults are most at risk.

Symptoms

Meniere’s disease symptoms typically occur in episodes. There are several symptoms of the condition. You will likely experience two or three of these symptoms at a time.

What are the first symptoms of Meniere’s disease? The first symptoms might be hearing loss, ringing in your ear, vertigo, and ear pressure.

Common Meniere’s disease symptoms:

• Loss of Hearing — You may experience hearing loss occasionally. Most people with this condition eventually lose hearing permanently. 
• Ringing in Your Ear — You may hear a sound in your ear. The sound may be ringing, buzzing, hissing, or whistling. This is referred to as tinnitus.
• Episodic Vertigo — Vertigo is the spontaneous sensation of spinning in a circle and sometimes is accompanied by nausea. Vertigo can last from 20 minutes up to several hours but rarely lasts longer than 24 hours.
• Ear Pressure — You might experience pressure or a sensation that feels like fullness in your impacted ear.

Causes

The cause of Meniere's disease is unknown. However, several causes exist. The most common cause is a buildup of fluid inside the inner ear. Several factors may contribute to the development of the condition.

Possible Meniere's disease causes:

• Genetics — People with a family history of the condition are more likely to develop Meniere's disease.
• Irregular immune response — A weakened immune system can result in an abnormal response to infections. Some researchers believe that Meniere's disease is an autoimmune disorder.
• Abnormal fluid drainage — A blockage or abnormality in the structure of your ear can slow the rate of fluid removal from your inner ear.
• Viral infection — A virus may play a role in the development of Meniere's disease.

Risk Factors

There are several Meniere’s disease risk factors. The three main risk factors are genetics, autoimmune disease, and allergies.

Risk factors:

• Genetics — A family history of Meniere's disease makes you more susceptible to the condition.
• Autoimmune disease — If you have an autoimmune disorder, then you are at increased risk for the disease. These disorders compromise your immune system, which renders your body less able to fight off infections.
• Allergies — There is a correlational link between allergic reactions and Meniere's disease symptoms.

If you have several of these risk factors, your chances of developing the condition increase.

Diagnosis

Diagnosing Meniere’s disease generally occurs after a Meniere’s disease test of your hearing and balance.

Hearing tests:

• Audiometry — An audiometry is a hearing test that measures how well you can hear faint sounds. It involves listening to a series of tones at different pitches volumes, and locations. An audiometry tells your doctor whether you have any trouble hearing sounds.
• Electrocochleography (ECog) — This test can show how well your ears pick up electrical signals sent from a device. 
• Auditory brainstem response (ABR) — An auditory brainstem response test is a noninvasive test that measures the electrical activity of the brain when it receives and responds to auditory information. Your doctor will attach electrodes to your scalp connected to a monitoring device. An ABR test can help identify whether a hearing problem is in your outer, middle, or inner ear.

Balance tests:

• Electronystagmography (ENG) test — This test assesses your eye movements in response to hot or cold fluid in a specific region of your inner ear.
• Rotary chair testing — Rotary chair testing involves you sitting in a chair that rotates while a doctor records your eye movements.
• Vestibular evoked myogenic potential (VEMP) testing — This test examines your sensitivity to sound. It helps doctors evaluate how well your inner ear and your brain work together.
• Posturography testing — During this test, you will wear a harness, stand barefoot, and respond to a series of balance challenges. The test helps your doctor pinpoint abnormal functioning in your balance system.

Treatment

There are four common forms of Meniere’s disease treatment. The four types of treatment include surgery, physical therapy, medication, and hearing aids. There is no cure for Meniere’s disease.

Surgery

Surgery is a rare form of treatment for Meniere’s disease. An endolymphatic sac procedure decreases fluid and increases drainage in your inner ear. This procedure is performed by making a small incision on the outer surface of the ear and inserting a long, thin tube into the opening to drain fluid within the middle ear.

Physical Therapy

You can do exercises to help with vertigo. These exercises will help your brain recognize and adjust to variations in the balance between your ears. A physical therapist can show you how to perform these exercises.

Medication

Medication is another common form of treatment for the condition. Your doctor may prescribe medication to reduce motion sickness, nausea, and vomiting. Your doctor may also give you medication to help reduce excess fluid in your body.

Hearing Aids

A hearing aid is a device that can help you hear more. An audiologist will give you a hearing aid and show you how to use it.

Prevention

Changing your lifestyle habits and nutrition can help with Meniere’s disease prevention. Your doctor will likely recommend that you alter your diet and patterns of rest.

Common prevention recommendations:

• Diet — Your doctor may ask you to limit or eliminate caffeine, alcohol, salt, chocolate, and Monosodium glutamate (MSG).
• Rest — Your doctor might recommend that you sit or lay down if you feel dizzy or unbalanced. Your doctor may also suggest that you rest during vertigo and immediately after an episode of vertigo.

If you or a loved one experience any of the signs and symptoms of Meniere’s disease, please contact an audiologist at Baptist Health.