What is Meniere’s Disease? Symptoms, Diagnosis & Treatment

Meniere’s disease is a condition of the inner ear that can lead to frequent episodes of vertigo (a type of dizziness in which you feel as if your head is spinning) and gradual hearing loss. It is a chronic health condition that generally affects only one ear.

What is Meniere’s Disease?

The exact cause of this ear disease is not known, but it is likely to occur due to an aggregation of various factors that lead to an abnormal quantity of fluid (endolymph) in the labyrinth (the inner ear). Some of the contributing factors might include –

• Genetic predisposition (a genetic characteristic that increases the chances of a person developing a certain disease)
• Abnormal immune response
• Viral infection

Blockage in the ear due to an anatomical deformity

Symptoms of Meniere’s Disease

Meniere’s Disease is a progressive condition. If you don’t address it , it can get worse with time. After an epidode , the symptoms of this disease may disappear totally for a significant period. The following are the signs and symptoms of the disease:

• Recurrent dizzy spells – These episodes come and go spontaneously without warning. When vertigo attacks, your head feels like it is spinning for a minimum of 20 minutes to a couple of hours. Severe and prolonged bouts can make you feel nauseous.
• Tinnitus – It is a ringing sensation in the ear which keeps you feeling like something is buzzing or hissing inside your ear. Tinnitus is not a health condition. It is a symptom indicating an underlying condition, and Meniere’s disease is one of them.
• Hearing loss – In the early stages of Meniere’s disease, your auditory (hearing) capacity might improve and decline at different points of time. However, in most cases, this condition leads to permanent hearing loss.
• Aural fullness – If you have this disease, you might feel pressure in the affected ear.

What are the complications of Meniere’s Disease?

Meniere’s Disease causes fatigue and stress. In extreme cases, it can also cause permanent hearing loss. Vertigo is another complication of this disease. Episodes of vertigo are unpredictable- it can suddenly cause loss of balance. There is always a risk of such accidents.

How to diagnose Meniere’s Disease?

Your doctor will perform the following tests to diagnose Meniere’s disease –

• Hearing test (audiometry) – This test evaluates your hearing capacity at different volumes and pitches and how well you can differentiate between sounds that seem alike.
• Blood tests and imaging test – Your doctor can also perform imaging tests, like MRI and CT scan, and blood tests to rule out other health conditions that exhibit similar symptoms as Meniere’s disease, including multiple sclerosis, brain tumour, etc.

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Treatment of Meniere’s Disease

Unfortunately, there is no cure for Meniere’s disease. Medical professionals use various types of treatment to reduce the recurrence and intensity of vertigo. The treatment approaches include the following –

• Medication

1. Your doctor might prescribe medications to reduce the intensity of the dizziness. Pills for motion sickness are useful in lowering the spinning sensation and managing symptoms like vomiting and nausea. Anti-nausea drugs can also give relief from vomiting and nausea during a vertigo episode.
2. Doctors also use diuretics to reduce fluid retention in the body and advise you to check your sodium intake.

This combination works well on many patients in controlling the severity of the symptoms.

• Non-invasive treatments

Some people respond well to non-invasive therapies. It includes –

1. Rehabilitation – If regaining balance between rounds of vertigo is a problem for you, your doctor may advise Vestibular Rehabilitation Therapy or VRT. It is an exercise-based treatment plan to recover your balance.
2. Hearing aid – A hearing device for the affected ear can also improve your hearing
3. Positive pressure treatment – For stubborn vertigo that does go that easily, the Positive Pressure Treatment can be effective. You can do this process at your home with a Meniett pulse generator. This device generates waves of pressure that you can pass to your ear canal with the help of a ventilation tube. Doctors suggest doing it thrice a day for 5 minutes.

• Other procedures

If these non-invasive treatments do not deliver results, your doctor is more likely to recommend more procedures. It includes injections for the middle ear. This is likely to improve the symptoms.

• Surgery

If the attacks of vertigo are getting debilitating and hard to treat using other treatments, your doctor might consider surgery as an option.

1. Endolymphatic sac procedure – The endolymphatic sac helps in regulating the fluid levels of your inner ear. In this procedure, the surgeon decompresses the sac to reduce the level of excess fluid. In some cases, the doctor can fix a shunt to drain out the excess endolymph from your inner ear.
2. Labyrinthectomy – During this procedure, the surgeon will remove the balance end organs and cochlea (hearing organ) from your inner ear. Removing these organs eliminates the balancing issues. However, your doctor will recommend this to you only if there is a case of total or near-total hearing loss in the problem ear.
3. Vestibular nerve section – During this procedure, the surgeon removes the vestibular nerve (the nerve connecting the movement and equilibrium sensors in your inner ear to your brain). This surgery aims at improving vertigo symptoms while preserving the hearing part. The procedure requires general anaesthesia and brief hospitalization.

Precautions

Some precautions that will help you cope with this condition of dizzy spells are :

• During a vertigo attack, make sure to avoid doing things that can aggravate your symptoms, such as reading, watching TV, looking at bright lights, and doing different kinds of movements.
• After an episode of dizziness, take rest. Hastening to go back to normal might make your symptoms severe
• Be careful with your balance – If you have severe balance problems, avoid walking and driving.

Dietary regulations

Meniere’s Disease can impact your lifestyle and the overall quality of your life, including social life, family life, and efficiency. However, you can manage this health condition by eating right and bringing in some lifestyle changes. Some important pointers to remember are –

• Food with high salt content can increase fluid retention in your body, resulting in worsening of your symptoms. Experts recommend consuming less than 300 mg of sodium per day and evenly distributing your salt intake throughout the day.
• Caffeine, tobacco, and alcohol can affect the balance of fluid in your ears. So, it is advisable that you avoid these.

Frequently Asked Questions (FAQs)

1. What triggers Meniere’s disease?

According to many of Ménière’s patients, doing certain activities or some situations triggers the onset of a vertigo episode. It includes – emotional distress, work pressure, stress, fatigue, blood pressure fluctuations, other illnesses, certain foods, and increased salt intake.

2. Does Meniere’s disease go away?

This health condition is progressive. It means that it can worsen gradually. It progresses slowly in some people, and a bit faster in others, and some patients hit the remission phase for no clear reason. As there is no treatment yet, you cannot make this disease go away, but only manage the symptoms.

3. Can an MRI detect Meniere’s disease?

MRI scan is not for Meniere’s disease diagnosis. Your doctor can perform an MRI scan if you have vertigo and tinnitus to rule out any other illnesses, such as brain tumours, brain lesions, or multiple sclerosis.