What is Ménière's disease?
Ménière'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. Although the dizziness can be very disabling, it
can usually be controlled. There can be a significant hearing
loss, but complete deafness is rare.
How does it occur?
Deep inside the skull lies the inner ear, made up of the
fluid-filled tubes of the hearing and balance organs. If there is
too much pressure inside these tubes, your hearing or sense of
balance can be affected.
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 come and go. They usually last for hours or
days. There may be times when you do not have any symptoms for
weeks, months, or years.
How is it diagnosed?
Your healthcare 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
Ménière'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 stimulated. These tests are called
electronystagmography (ENG), electrocochleography, oto-acoustic
emission (OAE), and auditory brainstem evoked response (ABR). For
these tests, you are usually reclining in a quiet room with a
thermometer-like 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?
Usually the first step is to avoid possible triggers of an attack.
Your healthcare provider may ask you to eat a low-salt diet. A
low-salt diet can help prevent your body from storing too much
water. You may be asked to stop using caffeine or nicotine.
The most common medicines used to treat Ménière's are diuretics,
also called water pills. An example is hydrochlorothiazide (HCTZ).
It can help decrease the fluid pressure in the inner ear by
causing your body to get rid of salt and water through your
kidneys. Another commonly used medicine is niacin. It can improve
blood flow to the inner ear by making the small blood vessels
widen (dilate).
Your provider may give you an anti-dizziness medicine such as
meclizine (Antivert) to help with the symptoms. It helps with the
nausea and vomiting that often happen with dizziness, but it may
make you sleepy.
Allergies can trigger Ménière's symptoms, so your provider may
recommend allergy testing and treatment.
Physical therapy may help you learn how to keep your balance
better when you are dizzy.
Your provider may recommend hearing aids to help you hear better.
In severe cases you may need surgery to control the dizziness. One
type of surgery 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
in the other ear can work without interference.
How long will the effects of Ménière's disease last?
An attack typically lasts several hours. Attacks may come every
few days or every few years. Often Ménière's disease is a mild
illness and occurs just once. Sometimes symptoms last all your
life. 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?
- Follow your healthcare provider's instructions for medicine,
physical therapy, diet, and activity.
- Lie down and rest during an attack of Ménière's.
- Protect your hearing from loud noises such as loud equipment
on the job and loud music.
- Keep your follow-up appointments with your healthcare
provider.
- Call your provider if you are having new symptoms or your
symptoms are getting worse.
How can I prevent Ménière's disease?
If you and your healthcare provider can figure out what triggers
your attacks, avoiding these triggers may help prevent attacks.
This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
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