Meniere's disease is a disorder of the inner ear that causes periods of vertigo, tinnitus (ringing or roaring in the ears), a feeling of fullness or pressure in the ears, and fluctuating hearing levels on one side. The symptoms can can last minutes, hours or days and can come along without warning or triggers.
About Meniere's disease
It affects women and men equally, and most people develop it in their 40s, 50s or 60s. Overall, the condition is rare: Meniere’s disease impacts an estimated 1 in 1,000 Canadians, or about 0.2% of the population. It gets its name from the French physician Prosper Meniere, who described the condition in 1861.
What causes Meniere's disease?
There is no known cause for Meniere’s disease. The most widely accepted theory is that the episodes or attacks are caused by an abnormal amount of fluid (endolymph) in the inner ear.
Possible causes of endolymph imbalance include:
Symptoms of Meniere's disease
Meniere’s disease can be characterized by the following symptoms:
How is Meniere's disease diagnosed?
An otolaryngologist, also known as an ENT doctor, generally diagnoses Meniere’s disease. There is no single test that is “positive” for Meniere’s disease, so diagnosis is based on a series of tests, including one or more of the following:
Hearing testing: Regular tracking a patient’s hearing levels during and after attacks allows a hearing professional to appropriately treat any hearing loss. Proper amplification, such as hearing aids, can help with the hearing loss as well as potentially mask tinnitus.
Vestibular function and balance testing: These tests assess your inner ear function and how your body reacts to changes in your position. These include:
Blood tests and MRIs can be used to rule out disorders that cause similar symptoms to Meniere’s disease, such as brain tumors or multiple sclerosis.
The symptoms of Meniere’s disease can change over time. Vertigo may get better (or worse), but generally the tinnitus and pressure remain, and hearing loss gets worse.
How do you treat Meniere's?
There is no cure, so treatments are intended to help reduce the severity and frequency of attacks. Common treatments for management include:
Dietary restrictions: Try to limit your salt intake to less than 2,300mg per day and limit your caffeine to 100mg per day. Other suggestions include avoiding foods that may trigger migraine symptoms, such as MSG, chocolate, red wine, and some dairy and pickled products.
Lifestyle changes: Having a healthy, active lifestyle can help. Try to exercise regularly, quit smoking, reduce alcohol intake and get enough sleep.
Cognitive therapy and stress management: Your tinnitus and vertigo symptoms may improve when you better manage stress.
Vestibular rehabilitation therapy: Some patients find relief from an exercise-based therapy to help retrain their brain and body to balance. This type of treatment is recommended in later stages of Meniere’s disease.
Hearing aids: can be used as a hearing loss treatment and may also assist in masking tinnitus.
Alternative treatments: There are a variety of alternative treatments that have been suggested for Meniere’s—such as acupuncture, herbal supplements, hyperbaric oxygen, and tai chi. To date, there is no concrete evidence that these treatments will help.
Are there medications for Meniere's disease?
Medications focus on treating the various symptoms. These medications may be taken mouth or by injection. For example, motion sickness and anti-nausea medications may reduce spinning sensation and help control nausea. Injections treatments into the middle ear may improve vertigo symptoms. For example:
What about surgery?
If other, less invasive vertigo treatments do not work, one of the following types of surgery may be recommended:
How to get help
While there is no cure for Meniere’s disease, there are a wide variety of treatment options available to help alleviate the symptoms. If you feel fullness, tinnitus and/or dizziness, it is important to follow up with your health care provider or find a hearing care provider who can help get you started on a treatment plan.