Ménière’s Disease

What is Ménière’s disease?

Ménière’s disease is a problem that affects the inner ear. It causes sudden spells of severe dizziness that can last many minutes to hours. The dizziness is usually described as a feeling of spinning (vertigo). There is often some loss of hearing as well. It usually affects just one ear, but it can happen in both ears. The symptoms can be mild or severe. Although the dizziness can be very disabling, it can usually be controlled. There can be a significant hearing loss, but complete deafness is rare.

How does it occur?

Deep inside the skull lies the inner ear, made up of the fluid-filled tubes fluid-filled tubes that help you hear and keep your balance. The spells of dizziness are caused by an increase in fluid pressure in the inner ear. What causes the increase in pressure is not known.

What are the symptoms?

The most common symptoms are:

• a very severe sense of spinning that happens suddenly
• noise (ringing or buzzing) or an increase in noise in the ear when the dizziness starts
• loss of hearing in an ear that may get worse with an attack of dizziness
• a feeling of pressure or fullness in the ear

Symptoms may come and go. There may be times when you don’t have any symptoms for weeks, months, or years.

How is it diagnosed?

Your healthcare provider will ask you about your medical history. You will have a physical exam. Usually, you will need to see an ear, nose and throat doctor (otolaryngologist) to help make the diagnosis.

You will have a simple test of your hearing (an audiogram).

You may have some special tests of balance or special hearing tests. You may also need an MRI or CT scan of your ear and brain.

What is the treatment?

Usually the first step is to try to stop the dizzy spells by preventing the buildup of fluid pressure in the inner ear. Ways to do this include:

• Eat a diet low in salt (1500 to 2000 milligrams (mg) of salt per day).
• Limit or stop the use of alcohol and caffeine.
• Take medicine called a water pill, or diuretic, to help your body get rid of salt and water.

This treatment to lower fluid pressure is successful for most people with Ménière’s disease.

Sometimes allergies can cause or worsen Ménière’s symptoms. These include environmental and food allergies. Your provider may recommend allergy testing and treatment with allergy medicines or allergy shots.

If these treatments do not stop the attacks of dizziness, a number of other treatments may be tried.

• Medicine can be injected into the ear to stop the dizziness.
• Surgery is sometimes needed to stop the dizziness. For example:
  • a drain may be put in the drainage system of the inner ear to help drain excess fluid
  • the part of the inner ear that affects your sense of balance may be removed from the ear that is causing your symptoms (labyrinthectomy)
  • the balance nerve to the affected ear may be cut.

Your provider may give you an anti-dizziness medicine such as meclizine (Antivert) or valium to help with the symptoms. It helps with the nausea and vomiting that often happen with dizziness, but it may make you sleepy.

How long will the effects of Ménière’s disease last?

An attack typically lasts several hours. Attacks may come every few days or every few years. Often Ménière’s disease is a mild illness and can be controlled with medicine. Sometimes symptoms last all your life. Even if the dizzy spells are stopped, you may keep having ear noise and hearing loss. Sometimes a hearing aid can help with these symptoms.

How can I take care of myself?

• Follow your healthcare provider's instructions for diet and medicine.
• Lie down and rest during an attack of Ménière’s.
• Call your provider if you are having new symptoms or your symptoms are getting worse.

How can I prevent Ménière’s disease?

The cause of Ménière’s disease is not known. It is sometimes related to eating too much salt. Eating a low salt diet may prevent the onset of Ménière’s disease.