What is Meniere’s disease?
Meniere’s disease is an inner ear disorder that causes vertigo, hearing problems and a ringing sound in the ear. In most patients, Meniere’s disease only affects one ear.
According to the National Institute on Deafness and Other Communication Disorders, there are approximately 615,000 people in the United States who have been diagnosed with Meniere’s disease and approximately 45,000 new cases are diagnosed each year.
If left untreated, Meniere’s disease can lead to progressive loss of balance as well as hearing function due to the pressure buildup on the inner ears.
Causes of Meniere’s disease
Although the exact cause of Meniere’s disease is not known, it is believed to be caused by changes in the inner ear fluid. Other potential causes include:
- Autoimmune disease
Risk factors for Meniere’s disease
Most patients develop Meniere’s disease between the ages of 40 and 50.
Symptoms of Meniere’s disease
Most patients experience two or more Meniere’s disease symptoms including:
- Vertigo episodes that recur on a regular basis — if you are having recurrent episodes of vertigo that start and stop without warning, it could be a sign of Meniere’s disease; episodes can last anywhere from 15-20 minutes to a few hours.
- Hearing loss — you may have temporary hearing loss, which can lead to permanent hearing loss.
- Tinnitus — ringing, buzzing, roaring, whistling or hissing in the ear may be a sign of Meniere’s disease.
- Full feeling in the ear — pressure in the affected ear or on the side of the head is a symptom of Meniere’s disease.
- Loss of balance
- Nausea, vomiting or sweating
Meniere’s disease episodes can occur days, weeks or years apart. You may feel completely well, and an episode may appear out of the blue.
Diagnosis of Meniere’s disease
Meniere’s disease is typically diagnosed by an otolaryngologist. During a clinic visit, your doctor will take your medical history and conduct a physical exam.
If you have the following confirmed issues, you may have Meniere’s disease:
- Hearing loss — verified by a hearing exam
- Feeling fullness in the ears
- Tinnitus — ringing in the ear
- At least two confirmed episodes of vertigo that last more than 20 minutes but not longer than 24 hours
Diagnostic tests to confirm Meniere’s disease may include:
Hearing exam (Audiometry)
Patients who are diagnosed with Meniere’s disease typically have difficulty hearing low frequencies or combined high and low frequencies but are able to hear normally in the mid-range frequencies.
Most patients with Meniere’s disease have normal balance in between vertigo episodes. Your doctor may order tests that evaluates the inner ear function such as:
- Videonystagmography (VNG) — assesses your eye movement to check your balance function.
- Rotating chair testing — evaluates the function of your inner ear based on your eye movement.
- Vestibular evoked myogenic potential (VEMP) — evaluates the sensitivity to sound in the inner ear.
Because the symptoms of Meniere’s disease are similar to other medical conditions, your doctor may order additional tests to rule out any other cause of your symptoms.
Tests may include:
- Blood tests — can help determine if you have diseases such as multiple sclerosis or a tumor in the brain.
- MRI scan or CT scan — can determine if you have other issues with your brain or neurological system.
Treatment of Meniere’s disease
Although there is not a cure for Meniere’s disease, treatments can help relieve or stop the symptoms associated with vertigo.
Treatments for Meniere’s disease include:
Medication can help relieve vertigo symptoms associated with Meniere’s disease. There are a variety of medications your doctor could choose for motion sickness, nausea, vomiting or fluid buildup in the inner ear.
There are a variety of exercises that can help relieve symptoms of vertigo. A Mercy Health physical therapist can teach you the exercises that help your brain learn to account for the balance differences between the ears.
Hearing aids can treat hearing loss.
Patients with severe Meniere’s disease may require surgery if other more conservative treatments have not been successful. Typically, your doctor will perform an endolymphatic sac procedure to help reduce fluid production and promote drainage in the inner ear.