Description

Meniere's disease is an inner ear problem that can cause dizziness, also called vertigo and hearing loss. Most of the times, the disease-Meniere's disease affects only one ear.

Meniere's disease can occur at any age. But it usually starts between the ages of 40 to 60. It is believed that it is a condition for life. But some treatments can help relieve symptoms and decrease how it affects your life in the long term.

Symptoms

The symptoms of Meniere's disease are:

  • Regular dizziness. You have a spinning sensation that starts and stops suddenly. Vertigo may begin without previous notice. It usually takes 20 minutes to 12 hours, but not more than 24 hours. Serious vertigo can cause nausea.
  • The hearing loss. Hearing loss in Meniere's disease may come and go, especially in the beginning. Over time, the hearing loss may be long-lasting and that can not improve on.
  • Ringing in the ear. Ringing in the ear is called tinnitus. Tinnitus is the term for when you have a ringing, buzzing, roaring, whistling or hissing in the ear.
  • Feeling of fullness in the ear. People with Meniere's disease often feel the pressure in the ear. This is called aural fullness.

After an attack of vertigo, symptoms improve and they can disappear for a while. Over time, many attack of vertigo that may decrease.

When to see a doctor

Consult with your healthcare provider if you have symptoms of Meniere's disease. Other illnesses can cause these problems. Thus, it is important to find out what is causing your symptoms as soon as possible.

Causes

The cause of Meniere's disease, is not known. The symptoms of Meniere's disease may be due to excess fluid in the inner ear called the endolymph. But it is not clear what causes this accumulation of fluid in the inner ear.

The problems affecting the fluid, which could lead to Meniere's disease include:

  • Poor drainage of fluid. This may be due to a blockage or irregular shape of the ear.
  • Autoimmune disorders.
  • The Viral infection.
  • Genetics.

Because no single cause has been found, Meniere's disease is likely to have a combination of causes.

Risk factors

Meniere's disease is more common in people between the ages of 40 to 60. Women may have a slightly higher risk than men.

You may have a greater chance of contracting the disease Meniere's disease, if someone in your family has had the condition.

You may have a higher risk of Meniere's disease if you have an autoimmune disorder.

Complications

The most difficult complications of Meniere's disease may be:

  • Unexpected attack of vertigo.
  • The possibility of losing your hearing in the long term.

The disease can occur at any time. This can cause worry and stress.

Vertigo can cause you to lose balance. This may increase your risk of falls and accidents.

Diagnosis

Your healthcare provider makes a exam and asks about your health history. A Meniere's disease, the diagnosis must include:

  • Two or more attacks of vertigo, each lasting 20 minutes to 12 hours, or up to 24 hours.
  • Hearing loss demonstrated by a hearing test.
  • Tinnitus, or a feeling of fullness or pressure in the ear.

Meniere's disease may have similar symptoms that are similar to other illnesses. Because of this, your doctor will need to rule out other conditions that you may have.

Hearing assessment

A hearing test called audiometry. Audiometry see how well you can hear sounds at different pitches and volumes. Also you can test how well you can tell between words that sound the same. People with Meniere's disease often have problems hearing in low frequencies or combined high and low frequencies. They may have typical hearing in the midrange frequencies.

Balance assessment

Between the vertigo attacks, the balance returns to normal for most people with Meniere's disease. But you could have a course of balance problems.

Tests to study how the inner ear is working on are:

  • Electronystagmogram or videonystagmography (ENG or VNG). These tests measure the equilibrium by means of the study of eye movement. A part of the test looks at the movement of the eyes as well as your eyes follow a target. Part of the studies of movement of the eyes while her head is placed in different positions. A third test, called the caloric test, following the movement of the eyes, by the use of the changes of temperature to trigger a reaction in the inner ear. Your healthcare provider can use hot and cold air, or water in the ear to the caloric test.
  • Rotary-chair testing. As a VNG , this test measures how well the inner ear works based on the movement of the eye. You can sit in a computer-controlled chair that rotates from one side to another, which causes activity in your inner ear.
  • Vestibular evoked myogenic potential (vemp) test. This test uses sound to make parts of the inner ear active. Registers how the muscles react to that sound. You can display common changes in the affected ears of the people with Meniere's disease.
  • Dynamic posturography ct (CDP). This test shows that part of the system of balance depends on the majority, and the parties can cause problems. The parts of the balance system to include the vision, the inner ear or of the terms of feelings of the skin, the muscles, tendons, and joints. While wearing a safety harness, you stand barefoot on a platform. Then, keep the balance under different conditions.
  • Video head impulse test (vHIT). This test evaluates the performance of the eyes and inner ears work together. vHIT uses video to measure the eye reactions to sudden movements. While you focus on a point, his head turned quickly and unpredictably. If your eyes are moved out of the target when your head is activated, you have a reflection of the problem.
  • Electrocochleography (ECoG). This test examines how the inner ear reacts to sound. It can help to see if you have the accumulation of fluid in the inner ear. But this test is not given only for Meniere's disease.

Tests to rule out other conditions

Lab tests, imaging scans and other tests may be used to rule out conditions. Some other conditions can cause problems such as Meniere's disease, such as a brain tumor or multiple sclerosis.

Treatment

There is No cure for Meniere's disease. Some treatments may help to decrease the bad vertigo attack are and how long they last. But there are no treatments for permanent hearing loss. Your healthcare provider may be able to suggest treatments that prevent the worsening of the hearing loss.

Medications for vertigo

Your healthcare provider may prescribe medications to take during an attack of vertigo so it is less serious:

  • Motion sickness medication. Medications such as meclizine (Antivert) or diazepam (Valium), can decrease the sensation of vertigo, and help to control nausea and vomiting.
  • Medicines for nausea. Medications such as promethazine may control nausea and vomiting during an attack of vertigo.
  • Diuretics and betahistine. These medicines may be used together or alone to improve the vertigo. Diuretics reduce the amount of fluid in the body, which can reduce the amount of excess fluid in the inner ear. Betahistines relieve vertigo symptoms by improving blood flow to the inner ear.

Long-term use of medications

Your healthcare provider may prescribe a medication to reduce fluid retention and suggest limiting your intake of salt. This helps to control the intensity and the amount of Meniere's disease symptoms in some people.

Non-invasive therapies and procedures

Some people with Meniere's disease may benefit from procedures that do not involve surgery, such as:

  • Rehabilitation. If you have balance problems between the attack of vertigo, vestibular rehabilitation therapy can improve your balance.
  • Hearing aid. A hearing aid in the ear affected by Meniere's disease, which could improve their hearing. Your healthcare provider can refer you to an ear doctor, also called an audiologist, to talk about the best hearing aids for you.

If conservative treatments are not successful, your doctor may suggest more intense treatments.

Middle ear injections

The drugs injected and absorbed in the middle ear can help the symptoms of vertigo better. This treatment is performed in a care provider's office. The injections may include:

  • The gentamicin. This is an antibiotic that is toxic to the inner ear. It works by damaging the diseased part of your ear that causes vertigo. Your healthy ear, then, takes on the job of keeping the balance. But there is a risk of hearing loss.
  • Steroids. Steroids such as dexamethasone can also help to control the attack of dizziness in some people. Dexamethasone may not work as well as gentamicin. But it is less likely to cause more hearing loss.

Surgery

If vertigo attacks of Meniere's disease are serious and difficult to carry, and other treatments don't help, surgery may be an option. The procedures include:

  • Endolymphatic sac surgery. The endolymphatic sac assists in the control of fluid in the inner ear of the levels. This procedure relieves pressure around the endolymphatic sac, which can improve the fluid levels. Sometimes, a care provider places a tube in the inner ear to drain the excess fluid.
  • Labyrinthectomy. With this procedure, the surgeon removes parts of the ear that can cause vertigo, what causes the complete loss of hearing in the affected ear. This allows your healthy ear-to-be in charge of sending you information about the balance and hearing of his brain. Care providers can only suggest that this procedure if you have a hearing impairment or total loss of hearing in the ear sick.
  • Vestibular nerve section. This procedure consists of cutting the vestibular nerve in order to prevent information about the movement of the brain. The vestibular nerve sends the balance and the movement of information from your inner ear to the brain. This procedure usually improves vertigo and keeps the audience in the ear sick. Most people need medicine that you put them in a sleep-like state, so-called general anesthesia, and an overnight stay in the hospital.

Lifestyle and home remedies

You may be able to improve some of the symptoms of Meniere's disease with self-care tips. Think about trying these tips during an attack of vertigo:

  • Sit or lie down when you feel dizzy. Avoid things that may make the symptoms worse, as the sudden movement, bright lights, watching television or reading. Try to focus on an object that does not move.
  • Rest during and after the attacks. Do not rush to return to your normal activities. If you feel tired, rest in bed for a short time. Then, little by little and move around when you can. This helps the brain to reset the balance of signals.
  • Prepare for an attack ahead of time. Talk with your doctor about ways in which you can prepare for an attack of vertigo. Talk about the medicines you can take for dizziness. And ask about when to go to the hospital or how to prevent injuries such as a fall.

Lifestyle changes

To avoid the risk of an attack of vertigo, try the following.

  • Limit salt. Consume foods and beverages having a high content of salt can increase the amount of water in your body. For the health in general, less than 2,300 milligrams of sodium per day. The experts also suggest that the dissemination of your salt intake evenly throughout the day.
  • Limit the consumption of caffeine, alcohol, and tobacco. These substances can cause vertigo attacks in some people. Try to keep a journal for tracking your symptoms and find the possible causes.

Coping and support

Meniere's disease can affect your social life, your productivity and the overall quality of your life. Learn all you can about your health problem.

Talk to people who have Meniere's disease, as in a support group. The members of the group can provide information, resources, support, and coping tips. Ask your healthcare provider or therapist about groups in your area or look up the information from the Vestibular Disorders Association.

Preparing for your appointment

It is likely that you first consult your family health practitioner. Your primary care physician may refer you to an ear, nose and throat (ENT) specialist, a hearing specialist (audiologist), or a nervous system specialist (neurologist).

Here are some tips to help you prepare for your appointment.

What you can do

When you make the appointment, ask if there is something that you need to do in advance, such as fasting before a test. Make a list of:

  • Their symptoms, especially those that have, during an attack, the duration and the frequency with which they occur.
  • Key personal information, including major stresses, recent life changes and family medical history.
  • All medications, vitamins or supplements that you are taking, including the dosage.
  • Have a friend or family member, if possible, to help you remember the information they give you.
  • Questions to ask your health care provider.

For Meniere's disease, some basic questions to ask your health care provider include:

  • What is likely causing my symptoms?
  • What are other possible causes of the symptoms?
  • What tests do I need?
  • Is my health problem likely is temporary or permanent?
  • What is the best option?
  • What are other options for the approach that you're suggesting?
  • I have other health conditions. How can I best manage them together?
  • There are restrictions that must be followed?
  • You should see a specialist?
  • Are there brochures or other printed material I can have? What websites do you suggest?

Do not wait to ask other questions.

What to expect from your doctor

Your provider is likely to ask several questions, such as:

  • When did the symptoms begin?
  • How often do you have symptoms?
  • How is the severity of your symptoms and how long they last?
  • What, in any case, it seems to trigger your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • It has had problems in the ear before? Does someone in your family has a history of inner ear problems?
Symptoms and treatment of Meniere's disease