Meniere's Disease

Overview

Meniere’s disease is an inner-ear disorder that can cause disabling bouts of vertigo (spinning, dizziness), hearing loss, and tinnitus (ringing in the ears). These symptoms are caused by excessive fluid buildup in the inner ear, an organ of both hearing and balance. There are more than half a million people with Meniere’s disease in the United States, with those between ages 40 and 60 most frequently affected. For many, the symptoms are not disabling, but for those with frequent vertigo or severe hearing loss, normal activities can become impossible or dangerous. Treatments include diet and lifestyle changes, diuretics (to reduce fluids), the injection of medication through the eardrum, and surgery.

Symptoms

In some patients, hearing loss and tinnitus can precede the vertigo by months or years; in others, they occur simultaneously. In 70 to 85 percent of cases only one ear is involved. The attacks of vertigo can last from 20 minutes up to several hours, and on rare occasions, up to 24 hours. Patients often feel a pressure or sense of fullness in the ears. Symptoms can occur many times a week or as infrequently as once a year.

Causes

The exact cause is unknown, but Meniere’s is thought to result from excessive fluid in the inner ear. This inner-ear fluid assists with balance and hearing. Normally, it is created and reabsorbed by specialized tissues within the inner ear. In Meniere’s patients, either too much fluid is produced or too little is reabsorbed. This fluid buildup damages the delicate sensory tissues that control balance and hearing.

Risk Factors

Possible contributors are stress, excessive salt intake, and, occasionally, endocrine problems. Other conditions that may act as triggers are infection and trauma. There may be an inherited predisposition. The peak incidence is in people aged 40 to 60.

Diagnosis

Diagnosis of Meniere’s disease involves hearing, balance, and imaging tests. Among other things, physicians may measure the electrical activity in the inner ear, test for changes in hearing sensitivity after the ingestion of a potent diuretic (which affects fluid retention), and monitor balance function. Balance function is tested in a number of ways. In one test, the patient’s balance is challenged by a moving platform and his or her bodily reactions are analyzed. In another test, a patient is seated in a dark room and rotated. The movements made by the patient’s eyes during this procedure can be used to measure the health of the balance organs.

Complications

Left untreated, Meniere’s disease can be so debilitating that patients may no longer be able to work or drive because of disabling vertigo. The hearing loss may progress to near deafness.

Recovery

Most patients find relief from symptoms through diet, medical therapy, and lifestyle changes alone.

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