Meniere's Disease Information

Also known as endolymphatic hydrops, Meniere's disease is a labyrinthine dysfunction that produces severe vertigo, sensorineural hearing loss, and tinnitus. It usually affects adults, men slightly more often than women, between the ages of 30 and 60. After multiple attacks over several years, this disorder leads to residual tinnitus and hearing loss.

There are an estimated 615,000 people in the US who have Ménière's disease, with 45,500 new cases diagnosed each year.

Causes

Meniere's disease may result from overproduction or decreased absorption of endolymph, which causes endolymphatic hydrops or endolymphatic hypertension, with consequent degeneration of the vestibular and cochlear hair cells.

This condition may stem from autonomic nervous system dysfunction that produces a temporary constriction of blood vessels supplying the inner ear. In some women, premenstrual edema may precipitate attacks of Meniere's disease.

Signs and symptoms

The symptoms of Meniere's disease include dizziness, a feeling of fullness in the ear and tinnitus (a roaring sound in the ear). The dizziness is described as a spinning or whirling feeling and may cause problems with balance (feeling unstable while walking). Some people feel nauseated and vomit during an attack (because of the spinning feeling). Some people also notice some hearing loss, especially with sounds that have a low tone.

Diagnosis

The presence of all three typical symptoms suggests Meniere's disease. Audiometric studies indicate a sensorineural hearing loss and loss of discrimination and recruitment. Electronystagmography, electrocochleography, a computed tomography scan, magnetic resonance imaging, and X-rays of the internal meatus may be necessary for differential diagnosis.

Treatment

The goal of treatment for Meniere's disease is to manage your symptoms and prevent or decrease the number of attacks. Treatment may include:

• Surgery - Several types of surgery are effective for treating the balance problems of Ménière's disease. The most common surgical treatment is the insertion of a shunt (silicone tube) to drain of excess fluid.
• Medication - Medications may be given to control allergies, reduce fluid retention, or improve the blood circulation in the inner ear.
• Change in diet - Eliminating caffeine, alcohol, and salt may reduce the frequency and intensity of symptoms.
• Behavior therapies - Reducing stress may lessen the severity of the disease symptoms.
• Rehabilitation - If you experience problems with your balance between attacks, you may benefit from vestibular rehabilitation therapy. The goal of this therapy, which may include exercises and activities that you perform during therapy sessions and at home, is to help your body and brain regain the ability to process balance information correctly.

Prevention

There is no known prevention for Meniere's disease, but prompt treatment of ear infection and other related disorders may be helpful.

You may also have to limit the stress in your life or learn how to deal with stress better, since stress may cause an attack. Let your family, friends and co-workers know about the disease. Tell them how they can help you if you have an attack.