According to the National Institute on Deafness and Other Communication Disorders, more than 600,000 people are affected by Meniere’s disease. However, as many as 2% of the population think they have this condition when they don’t. Here are the things you need to know about this condition.
What Is Meniere’s Disease?
Meniere’s disease is an affliction of the inner ear. Symptoms of Meniere’s disease include a feeling that the ear is plugged, hearing loss, tinnitus, and severe dizziness (in the form of vertigo). Each ‘attack’ strikes somewhat randomly. Some people have attacks that take place over a long period, while others experience frequent attacks over several days.
The vertigo associated with this condition is occasionally strong enough to make people fall – and as with all falls, this can lead to injury or even death. Some people only experience mild symptoms, so frequent falls are not guaranteed.
Notably, the tinnitus (ear ringing) associated with Meniere’s disease tends to worsen just before the vertigo begins. Some patients use this as a warning sign.
The hearing loss tends to get worse over time and may become permanent if left untreated.
How Is It Diagnosed?
Meniere’s disease is diagnosed based on a physical examination and the history of symptoms. In most cases, doctors (usually doctors specializing in Meniere’s disease and other conditions of the ear) will perform an audiogram.
Doctors may also require one or more other tests. Common choices include Magnetic Resonance Imaging (MRI), Auditory Brain Stem Response (ABR), and Computer Tomography (CT scan) – most people don’t need more than one. These are used to check for tumors, which are fairly rare but can cause symptoms extremely similar to those of Meniere’s disease.
The diagnosis, however, is simply whether a person has the triad of symptoms: tinnitus, hearing loss, and dizziness. The diagnosis does not identify a cause of the condition.
When Can People Get Meniere’s Disease?
People can develop this condition at any age, though it rarely starts earlier than 20. Most people who develop Meniere’s disease do so between 40 and 60.
What Causes This Condition?
Meniere’s disease is caused by an increase of fluid in the inner ear. This is where several of the body’s most important sensory organs – including the cochlea (for hearing) and the semicircular canals (for balance) are located.
When the amount of fluid in this area is disrupted, the brain is tricked into thinking it’s rapidly moving to places where it isn’t – hence the intense feeling of vertigo.
Scientists do not know why this fluid buildup happens. So far, suggestions include things like:
- A constriction of blood vessels
- Autoimmune reactions
- Viral infections
- Genetic defects
- Spasm of the Tensor Veli Palatini
Without knowing what causes it, there’s no way to determine who is at risk. However, this condition does appear to be more common in families – hence the genetic component on the list.
About 85% of cases involve Meniere’s disease in one ear – having it on both sides is rare, but far from unknown. The condition occurs equally in both genders.
How Long Do Attacks Last?
The duration of each ‘attack’ of Meniere’s disease varies. In most cases, it ranges from as little as 20 minutes to as long as 4 hours.
How Often Do People Recover From Meniere’s Disease?
There is no cure for Meniere’s disease, but about 60% of people who develop it will either recover naturally or find ways of adequately controlling it. Some people will only experience relief through surgery.
By itself, Meniere’s disease is not particularly dangerous. However, the potential for serious side-effects – loss of control while driving, falling down stairs, etc. – means that it’s best to seek treatment as soon as possible.
Since Meniere’s disease usually manifests in clustered attacks interspaced by long periods of normal behavior, it is difficult to tell whether the condition has stopped or is simply on hold.
What Treatment Options Are Available?
There are many treatment options, some of which are distinctly more effective than others. Before beginning any treatment for this condition, talk to your doctor – your circumstances may affect the success of the options discussed below.
The main problem – vertigo – can be controlled in almost all cases.
Most people who develop Meniere’s disease are prescribed medication to help control the feeling of vertigo. While medicine can’t correct the cause of vertigo, they can often shorten its duration and reduce the overall severity. Common prescriptions include lorazepam, diazepam, glycopyrrolate, and meclizine.
It’s worth noting that many prescriptions aren’t specifically intended to treat Meniere’s disease. For example, lorazepam is an antianxiety medicine intended to help the body relax and not worry so much if it feels like it’s moving. More relevantly, lorazepam may trigger feelings of dizziness. This is why you should avoid things like driving or navigating stairs on your own until your doctor is sure your medicine is safe for you.
Some medications are not recommended for use beyond several months. If your symptoms persist, your doctor may change your prescription or suggest a different form of treatment, such as chiropractic, physical therapy, or surgery.
You may experience severe nausea as a result of Meniere’s disease or the medicine you’re taking. In cases like these, doctors typically prescribe suppositories. Drowsiness is another common side-effect.
One of the most common home remedies for Meniere’s disease is the restriction of salt in your diet. Normally, salt helps to retain fluid in your body – and if you have less fluid, you may be able to control the amount of fluid in your inner ear.
Unfortunately, this method is not known to be universally successful. However, some patients have reported that they were better able to control their dizziness, so this is worth trying for most people.
Some dietary items – like chocolate and alcohol – have been known to worsen the symptoms of Meniere’s disease. Talk to your doctor about which foods are known to affect the condition, and when possible, remove them from your diet.
One of the more direct approaches to treating Meniere’s disease is the use of injections. Corticosteroids are preferred for this and have a high success rate of reducing vertigo. More importantly, corticosteroids carry no risk of hearing loss. The same cannot be said about gentamicin, an antibiotic some doctors use.
Meniere’s disease can be dangerous if left untreated, but it’s usually not enough of a threat to be worth causing permanent disability.
Pressure Pulse Devices
Another at-home treatment option is the Meniett device, which uses micropulses to stimulate and control the inner ear. This device is considered safe by the National Institutes of Health, who recommend its use three times a day for as long as necessary. About four in five patients respond to this treatment.
It’s worth noting that the Meniett device is considered an ‘intermediate’ level treatment, so most patients will not go straight to using this. Medication is often preferred as a first treatment option, but your doctor may allow you to go straight to this device.
There seems to be a correlation between a structural shift in the upper neck and the spasming of the tensor veli palatini (the muscle that allows fluid to drain from the inner ear). Dr. Burcon published a case series of 139 patients with Meniere’s, all of which had experienced trauma to the cervical spine (most commonly auto accidents). Correction of the misalignment of the upper neck resulted in drastic reduction in Meniere’s symptoms from an average of 8.5 out of 10 to 1.4 over two years time.
In most cases, surgery is only recommended if other treatment options have failed. The exact procedure used varies based on individual circumstances, but usually falls into three categories:
- Endolymphatic Sac Shunt/Decompression: This procedure involves putting a small tube in to drain fluid. While the recovery time is short, control of Meniere’s disease is also temporary. The main point in its favor is that it has little chance of causing additional hearing loss, though this procedure does nothing to improve hearing.
- Selective Vestibular Neurectomy: This procedure involves cutting the nerve associated balance. In most cases, this permanently cures the vertigo. However, with the loss of the balance organ, patients often have worse balance than before and may need to adjust their lifestyle in response.
- Labyrinthectomy: This procedure involves deliberately destroying the hearing and balance organs in the inner ear. Like the selective vestibular neurectomy, this procedure has an extremely high rate of success. However, given the loss of hearing, it’s usually performed when a patient already has severe hearing loss in that ear (and, thus, the loss of the hearing organ is essentially negligible).
Are Alternative Therapies Effective On Meniere’s Disease?
Typically, no. While studies have been performed on options like herbal supplements, tai chi, and acupressure, there is no accepted evidence that these are effective for controlling Meniere’s disease.
That said, some alternative therapies can improve your health even if they don’t work on this particular problem, and many people use them for that purpose. Always tell your doctor about any therapies you’re using, since this could impact the effectiveness of your other treatment options.
What Should I Do During An Attack?
If possible, lie flat on your back and try to focus on a still object (not television or other moving entertainment). This will help your body orient itself and may help to reduce the sensation of vertigo. Since attacks can last for an extended period, some people fall asleep while waiting. This is okay – the attack is usually over by the time they wake up, and sleeping through it is easier.