Summary about Disease
Meniere's disease is a disorder of the inner ear that can lead to dizzy spells (vertigo) and hearing loss. In most cases, Meniere's disease affects only one ear. It can occur at any age, but it typically starts between the ages of 20 and 40. The disease is considered chronic, but various treatments can help relieve symptoms and minimize its long-term impact on life.
Symptoms
Meniere's disease symptoms include:
Vertigo: A spinning sensation that starts and stops spontaneously. Episodes occur without warning and usually last 20 minutes to several hours, but not more than 24 hours. Severe vertigo can cause nausea.
Hearing loss: Hearing loss in Meniere's disease may come and go, particularly early on. Over time, most people experience some permanent hearing loss.
Tinnitus: A ringing, buzzing, roaring, or hissing sound in the ear.
Aural fullness: A feeling of pressure or fullness in the ear. These symptoms may occur as episodes or attacks. The frequency of episodes varies among individuals. Some people have episodes close together, while others may have episodes separated by weeks, months, or even years.
Causes
The exact cause of Meniere's disease is unknown, but it is thought to be related to an abnormal amount of fluid in the inner ear (endolymph). Factors that may contribute to Meniere's disease include:
Genetic predisposition
Viral infections
Autoimmune reactions
Allergies
Head trauma
Migraines
Medicine Used
There is no cure for Meniere's disease, so treatment focuses on managing symptoms. Medications used to control symptoms include:
Motion sickness medications: Such as meclizine or dimenhydrinate, can reduce vertigo.
Anti-nausea medications: Such as prochlorperazine or ondansetron, can control nausea and vomiting during vertigo episodes.
Diuretics: Medications that reduce fluid retention may help control vertigo in some people.
Corticosteroids: Can be administered orally or injected into the middle ear to reduce inflammation.
Gentamicin: Injections into the middle ear to reduce vertigo, but carries a risk of hearing loss.
Is Communicable
Meniere's disease is not communicable. It is not contagious and cannot be spread from person to person.
Precautions
While there is no way to prevent Meniere's disease, some lifestyle modifications may help manage symptoms and reduce the frequency of attacks:
Low-sodium diet: Reducing salt intake may help regulate fluid levels in the inner ear.
Avoid caffeine and alcohol: These substances can affect inner ear fluid balance.
Quit smoking: Nicotine can worsen symptoms.
Manage stress: Stress can trigger attacks. Relaxation techniques, such as yoga or meditation, may be helpful.
Adequate sleep: Ensure sufficient rest to help manage symptoms.
How long does an outbreak last?
An individual vertigo episode (attack) typically lasts from 20 minutes to several hours, but rarely lasts more than 24 hours. The period between attacks is variable, ranging from days to weeks, months, or even years.
How is it diagnosed?
Diagnosis of Meniere's disease typically involves:
Hearing test (Audiometry): To assess hearing loss.
Balance tests: To evaluate inner ear function and balance. (e.g., videonystagmography (VNG), rotary chair testing, vestibular evoked myogenic potentials (VEMPs), and posturography)
Electronystagmography (ENG): Measures eye movements to assess balance function.
Vestibular Evoked Myogenic Potentials (VEMP) Helps to assess function of specific parts of the vestibular (balance) system.
Electrocochleography (ECoG): Measures electrical activity in the inner ear.
MRI of the head: To rule out other conditions that may cause similar symptoms, such as acoustic neuroma. The American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) has established diagnostic criteria for Meniere's disease.
Timeline of Symptoms
The timeline of Meniere's disease symptoms varies greatly among individuals, but it can typically be characterized in stages:
Early stage: Episodes of vertigo, tinnitus, fluctuating hearing loss, and aural fullness. Symptoms may come and go, and hearing may return to normal between episodes.
Middle stage: Vertigo attacks may become less frequent, but tinnitus and hearing loss may worsen. Balance problems may persist between attacks.
Late stage: Vertigo episodes may be rare, but chronic balance problems, persistent tinnitus, and significant hearing loss are common.
Important Considerations
Meniere's disease can significantly impact quality of life. Support groups and counseling can be helpful.
Driving or operating heavy machinery should be avoided during vertigo episodes.
Inform employers and family members about the condition.
Hearing aids may be beneficial for managing hearing loss.
Surgery, such as endolymphatic sac decompression or vestibular nerve section, may be considered in severe cases that do not respond to other treatments.
Fall prevention strategies, such as using assistive devices, may be necessary due to balance problems.