Meniere’s disease is a chronic condition that causes periodic bouts of vertigo, ringing in the ears, a sense of ear fullness, and hearing loss. It affects the inner ear, the innermost part of the hearing system that also has organs of the vestibular system, which is important for balance.
It isn’t the most common cause of vertigo, so your healthcare provider may have to conduct a variety of tests to rule out other causes. We don’t have a cure for the disease, but you can manage symptoms with medication, prevention strategies, and, in some cases, procedures or surgeries.
Meniere’s disease may affect around 4 people in 10,000, and it’s more common in women than in men. The French doctor Prosper Meniere first described the disease in the 19th century. It also sometimes goes by the term “idiopathic endolymphatic hydrops.”
People with Meniere’s disease experience periodic attacks of symptoms. These attacks may last around two or three hours, but attacks may be shorter or as long as 12 hours. The frequency of these attacks varies a lot—they may be separated by weeks, months, or even years.
Vertigo is the symptom of Meniere’s disease that often bothers people the most. In true vertigo, the person experiences a sensation that they are rotating through their environment or that the environment is rotating around them. It’s different from dizziness that doesn’t have this rotational aspect.
During an attack, people with Meniere’s disease often have hearing loss, usually just in one ear. This is typically accompanied by tinnitus, a sense of ringing in the ears. Sometimes it also comes with a sense of pressure in the affected ear.
Sometimes people experience additional symptoms during an attack of Meniere’s disease, like nausea, vomiting, sweating, or diarrhea.
What Causes Meniere’s Disease?
Meniere’s disease affects your inner ear, found inside your skull. This area normally contains a fluid called endolymph, which is regularly produced and reabsorbed. In Meniere’s disease, something seems to interfere with reabsorption, or something might cause extra fluid to be produced. This causes the inner ear to bulge with extra fluid.
Researchers still aren’t clear what causes this fluid to build up in some people but not in others. Genetics seem to play a role, so you may have a higher risk if someone else in your family has had it. Some other factors and medical contexts that may be involved in causing Meniere’s disease include:
- Allergies to inhaled substances or to certain foods
- Autoimmune disease, in which the body’s immune system abnormally attacks part of itself
- Trauma to the inner ear
- Certain viruses, such as Epstein-Barr virus
- Presence of abnormal crystals in the inner ear, called otoconia
However, some people have Meniere’s disease but don’t seem to have any of these underlying factors.
Many different medical conditions can cause vertigo. For people who have never had a bout before, it’s especially important that medical professionals rule out other more potentially serious causes of vertigo, like a stroke or other brain problems.
There isn’t one single test or symptom that healthcare professionals can use to diagnose Meniere’s disease, but the person’s specific symptoms and medical history are critical.
A variety of tests can be performed to both assess for Meneire's disease as well as rule out other potential causes of your symptoms. These include:
- Physical exam: Your healthcare provider may check how your eyes move, look in your ears with a light, check your blood pressure sitting and standing, check your gait and your hearing, or see if your vertigo goes away after a series of movements.
- Blood tests: Blood tests aren’t helpful for diagnosing Meniere's, but they can rule out other conditions if the diagnosis is unclear. For example, since thyroid disorders can sometimes cause dizziness, you might get a blood test such as thyroid stimulating hormone.
- Magnetic resonance imaging (MRI): This is a detailed type of imaging test that is helpful to some people, especially if the cause is neurological. However, it can only rule out other diseases of the brain that might cause similar symptoms, like a brain aneurysm (bulging weakened blood vessel).
- Videonystagmography (VNG): This test assesses your eye movements as you track various lights or objects. It can show if the vestibular system is affected, as it is in Meniere's disease. However, it can’t eliminate other potential causes that also affect the vestibular system.
- Audiometry (hearing) tests: This might include a test that checks for the lowest volume at which you hear a sound as well as additional tests.
Who Diagnoses and Treats Meniere's Disease?
Your primary care provider may refer you to an ear, nose, and throat specialist—also called an ENT—to check your inner ear. If a neurological cause is suspected, they may also refer you to a neurologist, or a doctor who specializes in the brain and central nervous system.
Treatments for Meniere's Disease
We don’t have treatments that can make Meniere’s disease completely go away. But many people can reduce and manage their symptoms using medication, procedures, and/or pressure pulse treatment.
It’s important to manage any underlying conditions that might be worsening Meniere’s disease. So you might take an antihistamine drug, like Claritin (loratadine).
You might need a medication to help treat the immediate symptoms of vertigo. For example, Bonine (meclizine) and Ativan (lorazepam) are options in this category.
Additionally, diuretic medications which remove fluid from the body may also help reduce endolymph fluid and improve symptoms. Some possibilities are Microzide (hydrochlorothiazide) and Dyrenium (triamterene).
Healthcare professionals sometimes use injections to treat Meniere’s disease, although they don’t always successfully relieve symptoms.To perform an injection, an ear surgeon inserts a long needle through your ear canal and through your eardrum to deliver medications into that space (the middle ear). Sometimes they inject an antibiotic called gentamicin. Another option is a similar injection of corticosteroid medication.
A different approach is surgery on the inner ear itself, of which several options exist. One is labyrinthectomy, which removes portions of the inner ear. However, these surgical options carry risks, and they don’t work for everyone.
Pressure Pulse Treatment
A new option for Meniere’s disease is pressure pulse treatment. Several times a day, you fit a device into your outer ear, and the device delivers intermittent air pressure. This may help reduce attacks of vertigo, but we’re not yet clear how well it works.
Scientists haven’t identified a way to prevent Meniere’s disease from happening in the first place. Fortunately, by taking certain steps, you may be able to reduce your risk of future attacks. These include:
- Getting enough sleep at night
- Eating regular meals
- Doing activities to remain physically active, but not to the point of severe fatigue
- Eating a diet lower in sodium
- Limiting the use of caffeine and alcohol
- Avoiding smoking
Mental health also seems to play a role in Meniere’s disease in potentially triggering disease symptoms. Finding ways to work with and manage your stress, such as via talk therapy, may help.
Many people with Meniere’s disease eventually develop permanent hearing loss in their affected ear (hearing loss even when an attack isn’t going on). In these cases, the inner ear has become permanently damaged.
Hearing loss usually affects lower tones before higher ones. Few people entirely lose their hearing in the affected ear, even in the later stages of the disease.
Such hearing loss has more impact on the minority of patients who have Meniere’s disease which affects both of their ears.
Strict management of Meniere’s disease may help slow hearing loss. A 2022 study of 154 people with Meniere's disease found that around 87% of people who had strictly followed their dietary, lifestyle, and treatment plans had either no hearing loss a year later or even slightly improved hearing.
Some people with Meniere’s disease have only widely intermittent attacks that don’t interfere with their life too much. Other people may have more severe and frequent attacks that can cause disability.
Most people with Meniere’s disease can continue to drive safely if they have attacks that give warning signals that they are coming on. Whether or not you should drive should be discussed with your healthcare provider.
Meniere’s disease is a chronic condition—one that you’ll have to find ways to manage over time. Many people learn about the things that seem to trigger attacks for them. It’s also important to find healthy ways to manage your stress, which may also help prevent attacks.
Frequently Asked Questions
What is the average age people get Meniere's disease?
Most typically, people get first symptoms of Meniere’s disease between the ages of 40 and 60.
Does anxiety trigger Meniere's disease?
A lot of people with Meniere’s disease report that stressful life events and anxiety sometimes trigger their symptoms. Overall, people with Meniere’s disease seem to be a little more prone to symptoms of stress and anxiety. However, even if stress and anxiety are triggers, they aren’t the full cause.
Learn More:The Effects of Stress on the Body
Does Meniere's disease go away?
Meniere’s disease does not usually go away, although the attacks are temporary. However, some of the other potential causes of vertigo do sometimes go away with time or treatment.
What is the difference between vertigo and Meniere’s disease?
Vertigo—the uncomfortable sensation that you or your environment are spinning around—is one of the main symptoms of Meniere’s disease. However, it is not the only medical problem that can cause vertigo; other causes for it are more common.
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