Webpage published: 2012
We explain the causes, effects, treatment, and management of Menieres disease, with links to personal testimonies and useful organisations:
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
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.
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’.
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.
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.
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.
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.
Special balance (vestibular) exercises may be suggested if you have any dizziness or imbalance between attacks.
You might be referred to a specialist tinnitus clinic for more help and advice if you have tinnitus between attacks.
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.
If you have ongoing difficulty adapting to and coping with your symptoms, counselling or other complementary therapies might also be useful.
Sometimes surgery or treatment applied directly to the inner ear on the affected side might be suggested by your ENT specialist.
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.