Meniere's Disease

What is Meniere's disease?

Meniere's disease is a problem in the inner ear. It can cause severe dizziness (vertigo) and hearing loss. It usually affects just one ear, but it can happen in both ears. The symptoms can be mild or severe. The dizziness can be very disabling. There can be a large hearing loss, but complete deafness is rare.

How does it occur?

There is a build-up of fluid and pressure in the inner ear. The inner ear contains organs for balance and hearing. When the balance organs are affected, you feel dizzy. When the hearing organs are damaged by the pressure and fluid, your hearing is decreased. Both dizziness and hearing problems may happen at the same time.

What causes the build-up of fluid and pressure is not known, but it is known to happen after some infections, such as syphilis, and after head injuries.

What are the symptoms?

The most common symptoms are:

• pressure or fullness in the ear
• ringing in the ear
• dizziness
• difficulty hearing.

These symptoms may occur one at a time or together. They may come and go. They usually last for hours or days. In between attacks of symptoms, you may have weeks, months, or years go by without any symptoms.

How is it diagnosed?

Your health care provider will ask you about your medical history. You will have a physical exam of your eyes, ears, and nervous system. A simple test of your hearing, called an audiogram, will probably be done. Because there is no single test for diagnosing Meniere's, your provider may have you try different medicines to see if any of them help your symptoms improve or go away.

You may need special tests to check the hearing and balance mechanisms in your ear. These tests measure how well your brain and nervous system react when your nerve centers for balance and hearing are electrically stimulated. These tests are called electronystagmogram (ENG), electrocochleography, oto-acoustic emission (OAE), and an auditory brainstem evoked response. For these tests, you are usually put in a quiet room with a thermometerlike probe resting in your ear canal. These tests do not require needles or injections. You may also need an MRI scan of your ear and brain to make sure there are no tumors causing your symptoms.

What is the treatment?

The most common treatment is medication. You will be given medicines to help with your particular symptoms. Meclizine (Antivert) is the most common drug used to treat dizziness. It helps with the nausea and vomiting that often occur with dizziness, but it also makes you feel sleepy. Medicines to help your body lose fluids and decrease blood pressure may also be prescribed to try to lower the fluid and pressure problems in the inner ear. Diuretics such as hydrochlorothiazide and the blood vessel dilator, niacin, are examples of these kinds of drugs.

Your health care provider may ask you to go on a low-salt diet to help prevent your body from storing too much water.

Physical therapy may help you learn how to keep your balance better when you are dizzy.

You may need hearing aids.

In severe cases you may need surgery. One type of surgery that might be done involves making an opening to try to drain excess fluid out of the inner ear. In another type of surgery, the abnormal inner ear structures are removed so that the normal ones on the other side can function without interference.

How long will the effects of Meniere's disease last?

An attack may last a few minutes, hours, or days. Attacks may come every few days or every few years. Often Meniere's disease is a mild illness and occurs just once. But sometimes symptoms persist for a lifetime. In these cases the dizziness or hearing loss can be very disabling, making work or everyday tasks quite difficult.

How can I take care of myself?

To help take care of yourself:

• Follow your health care provider's instructions for medicine, physical therapy, diet, and activity.
• Lie down and rest during an attack of Meniere's.
• Protect your hearing from loud noises (such as loud equipment on the job and loud music).
• Keep your follow-up appointments with your health care provider.
• Call your provider if you are having new symptoms or your symptoms are getting worse.

How can I prevent Meniere's disease?

Because the cause of Meniere's disease is not known, there is nothing you can do to prevent it.