| Meniere's Disease FAQ |
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What is Meniere’s disease? Meniere’s is a disease with a poorly understood cause and a wide variety of symptoms. Basically, it’s an abnormality in the amount of fluid in the inner ear. That fluid affects both balance and hearing, so symptoms range from fluctuating hearing loss to vertigo. The disease is named for the 19th-century French physician who first described it. What causes Meniere’s disease? There are lots of theories but at this point no one knows for sure. Noise pollution, viral infections, immune deficiencies and allergies are among the suggested causes. It also may be genetic. And there may be different causes for different patients What happens in Meniere’s disease is that there’s too much or too little fluid in a part of the inner ear called the membranous labyrinth. When that happens, the tissues around the labyrinth expand, sending misleading signals to the brain. The labyrinth is essential for our sense of balance, so an irregularity in the amount of fluid can cause dizziness. What are the symptoms? Besides vertigo and occasional hearing loss, people with Meniere’s many also feel pain in the ear, or may experience tinnitus, a ringing or roaring the ear. When the vertigo is severe, it can lead to further symptoms, including nausea, vomiting and sweating. Patients may also feel a sense of “fullness” or pressure in the inner ear. Vertigo is often the worst symptom. The person may feel so dizzy that he or she has to lie down immediately; in fact, it’s not unusual for Meniere’s sufferers to suddenly fall down and injure themselves severely. It almost always starts in one ear, but often it spreads to the other ear as well. Are the symptoms constant? No, not usually. Though a few patients report a constant dizziness, most experience symptoms in spells. Some Meniere’s patients may go months or even years at a time without any symptoms. Others experience them daily. Often, the attacks come in clusters, with several episodes over a short period of time. The symptoms typically come on suddenly, with little or no warning. Usually, the vertigo, tinnitus and hearing loss all occur at once, though sometimes tinnitus or the hearing loss come on first. The symptoms usually last for a few hours but some patients experience very brief, even momentary, attacks. Often, the eyes “jump” (a condition called nystagmus) during the attacks. But there’s little consistency between attacks, even in the same Meniere’s patient. Each one could have a duration and combination of symptoms. How common is Meniere’s? Not very common, but far from rare. The National Institute on Deafness and Other Communication Disorders estimates that 615,000 Americans currently suffer from Meniere’s, and that 45,500 new cases are identified every year. That means that something like one in every 500 people has Meniere’s. That’s about the same percentage that suffer from multiple sclerosis, for example. Who’s likely to have Meniere’s? Most people who acquire Meniere’s disease start showing signs after age 40. It’s not gender-specific – men and women are equally likely to get it. How will I know if I have it? Other conditions besides Meniere’s can cause similar symptoms, so just because you have the symptoms doesn’t mean you have the disease. Your otologist will have to make the diagnosis. And it’s a complicated diagnosis even for an otologist. He or she will look at your medical history and conduct hearing and balance tests and then take a look at your inner ear with an MRI, and may perform an electrochocleograph test, which measures electrical impulses in the inner ear, to confirm the diagnosis. If I have Meniere’s, what should I do during an attack? Lie down immediately on a firm surface. Keep still and focus your eyes on a stationary object. Remain at rest until the vertigo starts to pass, and then get up very slowly. It’s best not to drink water, at least until the worst of the attack subsides, because you may vomit. After attacks, many patients feel the need to sleep, often for several hours. Is there a cure? No, not at this time. So, if my otologist tells me I have Meniere’s disease, what should I do? Do I just live with it? Even though there’s no cure, there are a variety of ways to alleviate symptoms, and many Meniere’s sufferers find they can greatly reduce the frequency and severity of attacks. Perhaps surprisingly, dietary changes are among the most effective treatments for some Meniere’s patients. Reducing salt intake and eliminating caffeine and alcohol can often be a big help. Medications that help blood circulation in the inner ear work for some patients too. Surgery is an option for people with severe vertigo. One option is to remove the labyrinth. That cures the vertigo, but it also means you won’t be able to hear out of that ear. Your otologist will only perform that procedure if you’ve already irrevocably lost hearing in that ear. There’s also a procedure called a vestibular neurectomy – the severing of a particular nerve -- that takes care of the vertigo and keeps hearing intact. But it’s a complicated and often risky procedure. Antibiotic treatments, with the antibiotic applied directly to the inner ear, have also shown some promise recently. Diuretics and a few other kinds of drugs are also prescribed. Your otologist can find the best course of treatment; don’t be discouraged if he or she has to try a few different medications or combinations of medications before finding the right treatment for you. Are there long-term effects? Yes. Although Meniere’s isn’t thought to lead to deafness, it can lead to some loss of hearing, especially at high and low frequencies. |