Overview

Definition

Menière’s disease is a chronic condition that causes moderate to severe vertigo and often results in permanent hearing loss. Your inner ear contains three semicircular canals tied to balance and equilibrium, known as the vestibular apparatus. These canals are fluid-filled tubes lined with fine hairs.

In a Menière’s attack, these canals overfill, resulting in serious problems. Menière’s disease frequently develops in patients between the ages of 20 to 50 and usually only affects one ear. If the condition persists untreated for a long time, however, there's an increased chance that it will spread to both ears. 

Causes

While the precise cause of Menière’s disease is currently unknown, scientists have a few ideas. One of the primary theories is it's tied to a rupture of the Reissner's Membrane, a thin cell membrane within the cochlea, a spiral-shaped cavity in the inner ear involved in hearing. When this membrane ruptures, a liquid known as potassium-poor perilymph leaks out, leading to increased pressure in the inner ear.

Viral infections may be another cause of the disease, as they often result in inflammation and excess fluids.

Symptoms

Three classic symptoms of Menière’s Disease are as follows:

  • Severe rotary vertigo lasting from several minutes to several hours.
  • Deafness, particularly in the deep tone range and usually just in one ear.
  • Tinnitus, or ringing in the ears.

Due to the long-lasting rotary vertigo that usually accompanies a Menière’s attack, many patients can suffer from severe nausea which may even result in vomiting. Other symptoms include severe sweating, trembling or twitching of the eye, or uncomfortable pressure in the ear. A patient's consciousness usually remains unaffected during an attack.

However, patients suffering from Menière’s Disease may experience severe anxiety, especially if they are undiagnosed and do not understand what is affecting them. As such, Menière’s also carries with it a definitive psychological impact which should not be overlooked. Days, weeks, months, or even years may pass between individual attacks.

On a positive note, the frequency of rotary vertigo attacks often decreases over the course of the disease.

Diagnosis

Because Menière’s Disease shares symptoms with multiple other hearing disorders, diagnosing it can be difficult. In most cases, the surest indicator that a hearing issue is caused by Menière’s and not another condition is that there is only hearing loss in one ear. In the beginning, deafness only occurs during an attack, and subsides afterward.

Prolonged illness, however, can result in permanent sensorineural hearing loss, particularly where deep tones are concerned. 

Treatment

Currently, there is no known cure for Menière’s Disease, as scientists are still attempting to pinpoint the exact cause.

However, treatments do exist, both for during an attack and as preventative measures. First, because dizziness and nausea are the most common symptoms, anti-vertigo and anti-nausea medication can be prescribed to a patient. A doctor may also prescribe a drug such as gentamycin to deactivate the vestibular apparatus, which may put an end to the patient's vertigo - this may, however, adversely impact the patient's hearing.

For more advanced cases, surgery may be an option. In some cases, severing the patient's balance nerve can put a permanent end to vertigo. Another common treatment is known as a sacculotomy, which involves poking a tiny opening into part of the inner ear to relieve pressure.

Although a permanent cure does not exist, a healthy lifestyle goes a long way towards improving the condition and helping a patient live with Menière’s Disease. Many people coping with the illness have reduced the frequency and severity of attacks by avoiding cigarettes, eating low sodium/high-potassium foods, and avoiding stressful situations. Regular exercise, balance training, and meditation may also be helpful.