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Meniere’s Disease 

Webpage published: 2012

 

Tony Long and his wife Sue, who has MenieresWe explain the causes, effects, treatment, and management of Menieres disease, with links to personal testimonies and useful organisations:

Where's the problem?

 

Meniere’s disease is a condition of the inner ear affecting balance and hearing. It is thought to be caused by unusually large amounts of a fluid called endolymph creating a build up of pressure in the inner ear. This pressure can cause the inner ear to send abnormal messages to the brain resulting in dizziness, vomiting and dulled hearing. The exact cause of Meniere’s disease is not known but there may be links to circulation problems, viral infections, allergies, the immune system, migraines, or genetic factors.

The ear is divided into three sections:

  • The outer ear consisting of the pinna, ear canal and eardrum
  • The middle ear consisting of the ossicles and ear drum
  • The inner ear consisting of the cochlea, the auditory (hearing) nerve and the brain

Diagram of the ear: meniere's disease

People who have problems with the outer and middle ear have conductive deafness (e.g. ear infection, hole in the eardrum, otosclerosis). People who have problems with the inner ear have nerve deafness. Nerve deafness can be caused by things such as old age, loud noise or Meniere’s Disease.

What causes Menieres?

 

Meniere’s disease is a disorder of the inner ear that causes balance and hearing symptoms. In your inner ear is the organ of hearing (cochlea) and inside the cochlea are various chambers – one of which contains a fluid called endolymph. Menieres ‘attacks’ are thought to be triggered by too much endolymph causing pressure in the cochlea - the hearing cells and balance cells in the inner ear are damaged during an ‘attack’. 

Diagram of the inner ear: meniere's disease

The cause of this pressure is not yet fully understood although there are several possibilities under investigation. The Meniere’s Society states that the disease affects between 1 in 2000 and 1 in 20,000 people. It commonly starts between the ages of 20 and 50 but can occur at all ages and in either sex. 

There is also thought to be the possibility of a family link to the disease.

Symptoms

 

The symptoms of Meniere’s disease can be distressing, and the unpredictable nature of the condition can significantly affect quality of life. A correct diagnosis is important as this allows the most effective treatments to be used to try to minimise the effect of symptoms on the lives of those with the disease. 

During an ‘attack’, people with Meniere’s disease usually experience a trio of symptoms:

  • spinning dizziness (vertigo)
  • noises in the ear (tinnitus)
  • hearing loss in the affected ear  

The symptoms experienced can change over time and the disease can be split into 3 stages – read more about this at the Meniere’s Society website. 

Meniere’s disease occurs in repeated ‘attacks’ or episodes lasting from minutes to hours. The time between ‘attacks’ varies from weeks to years and is very unpredictable. Some people can tell an ‘attack’ is going to start because of a blocked feeling in the affected ear. 

Usually, the disease affects only one ear, however the Meniere’s Society suggests that up to 50% of sufferers have a progression of the disease to affecting both ears. During an attack, people with the disease may be unable to carry on with their daily life until the symptoms have started to improve. They may also feel nauseous and might be sick. 

Diagnosis

 

If your GP suspects that you have Meniere’s disease, they will usually refer you to an ENT specialist for further assessment.  

A hearing test is usually done which will show any hearing loss on the affected side. Meniere’s disease often causes a low pitch (low frequency) sensori-neural hearing loss in the affected ear. The hearing loss may change during ‘attacks’ but usually becomes permanent with repeated damage. Your ENT (Ear, Nose and Throat) specialist might also request specialist balance (vestibular) testing which may help to identify the affected ear.     

Other tests such as scans or blood tests might be done to help rule out other illnesses that may cause the three common symptoms of Meniere’s disease: vertigo, tinnitus and hearing loss. A diagnosis is usually based partly upon the pattern of symptoms that an individual is suffering. There is no cure for Meniere’s disease however there are medications and other treatments that may improve symptoms. If medication is found to improve the symptoms, the diagnosis can be more strongly confirmed. 

Treatment

 

  • Medication

Your GP or ENT specialist might prescribe medication to help make attacks less severe and occur less often. This might be medication for your balance or medication to reduce water retention (diuretic). Your doctor might also suggest that you reduce the amount of salt in your diet. 

  • Balance exercises

Special balance (vestibular) exercises may be suggested if you have any dizziness or imbalance between attacks.

  • Tinnitus support

You might be referred to a specialist tinnitus clinic for more help and advice if you have tinnitus between attacks.

  • Hearing aids

If you have hearing loss in the affected ear and also notice that you have difficulty hearing clearly, a hearing aid may be helpful to you.

  • Counselling

If you have ongoing difficulty adapting to and coping with your symptoms, counselling or other complementary therapies might also be useful.

  • Surgery

Sometimes surgery or treatment applied directly to the inner ear on the affected side might be suggested by your ENT specialist. 

 

Further information

 

Although Meniere’s disease can be very frightening, seeking help and appropriate treatment can help to minimise the effect of symptoms on your life. Learning to manage your symptoms will allow you to continue with your daily activities as much as possible. Contact us for advice, information and support.

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 My life with Menieres

Gerry Leeper: My life with Menieres 

My name is Gerry Leeper. I have Ménière’s disease. With Ménière’s you get things which I know now are called ‘drops’ where you can be walking along and you just suddenly drop and you’re dizzy and lying on the ground and you do not know how you got there.'

I was sitting in our house with my youngest boy, he was three at the time, and I got up to walk across the room and I adjusted the television set and the next thing I knew I was lying on the floor and the room was spinning round and I was really very, very ill and sick.

I was able to speak to my son and he actually ran across the road and got a neighbour.

I was in hospital for a week and they didn’t know what had occurred but after three months of going back and forward to the GP I was sent to hospital outside Glasgow.

They put me on a big table and put water in my ears and I was very ill and they surmised from that I had Ménière’s disease. Read Gerry's story.

 

Mine's not a pint

Blogger Tony on wife Sue's Menieres

Tony Long blogs about his wife Sue's Menieres Disease

Meniere’s is a sneaky, cheating, ambushing disease which after hitting hard, making life unbearable, hides only to pounce when least expected.

When Sue’s Menieres was worst we went camping to get away from everything. Rather than relaxing, she became too unwell to leave the tent much. I researched conditions and found that air pressure had fluctuated during our stay and suggested that as a trigger to her Consultant who pooh-poohed that as clutching at straws.

The following year he mentioned research had proved air pressure was a trigger. We also realised our big, multi-dome, tent’s (curving) walls shimmied in the breeze robbing Sue of visual reference points. Bought a large tunnel tent, which helped a lot.

Driving home Sue passed out a few times and became very sick. At one picnic area as she crawled around looking for a clean patch to ‘violate’, once-happy picnickers put their sarnies back in the basket – or bin! My anxiety rocketed each time I cleaned her, but all I could do was drive home as carefully as possible. She improved slowly and in time we became used to MD attacks which have eased off now...

So many regard sufferers as drunks which is why Sue won’t let me drive by someone slumped in the street, they could have MD rather than a skin full. Follow Tony's blog.

Useful organisations

Meniere’s Society

Action on Hearing Loss

NHS Choices

British Tinnitus Association

 

Thanks to Ann-Marie Hawkins, Senior Audiologist at the University Hospitals of Coventry & Warwickshire for her support in creating this page.

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