Meniere’s disease is a disease of the inner ear and has symptoms such as dizziness, related balance problems and hearing loss. Although the cause of Meniere’s disease is unknown, it is likely due to an abnormality in the way the fluid of the inner ear is regulated. In most cases, only one ear is affected. You can find more information below.
What is Meniere’s disease?
Meniere’s disease is a disease that can cause dizziness (vertigo) and hearing loss associated with pressure in the inner ear. In most cases, this disease affects only one ear. Meniere’s disease can occur at any age, but it usually begins between young and middle-aged adulthood. It’s considered a chronic condition, but a variety of treatments can help relieve symptoms and minimize the long-term impact on your life.
What causes Meniere’s disease?
The cause of Meniere’s disease is unknown. The symptoms of Meniere’s disease appear to be the result of an abnormal amount of fluid ( endolymph ) in the inner ear, but it is not clear how or why this happens.
Possible factors affecting fluid that may contribute to Meniere’s disease include:
- Improper fluid drainage due to obstruction or anatomical abnormality
- abnormal immune response
- viral infection
- genetic disposition
Since no single cause has been identified, it is likely that Meniere’s disease is caused by a number of factors.
What are the symptoms of Meniere’s disease?
Symptoms of Meniere’s disease include:
- Recurrent attacks of vertigo: In this case, there is a sudden onset of spinning sensation. Just as we will feel that you are spinning, you may also feel that things around you are spinning. Vertigo attacks occur without warning and usually last from 20 minutes to several hours, in some cases lasting no more than 24 hours. Severe vertigo can cause nausea.
- Hearing loss: Hearing loss in Meniere’s disease may occur especially in the early period. Eventually, most people have permanent hearing loss.
- Tinnitus: Tinnitus is the perception of a ringing, buzzing, roaring, whistling, or hissing sound in your ear.
- Fullness in the ear: People with Meniere’s disease often feel pressure/fullness in an affected ear.
After a while, the symptoms improve and may disappear completely. The frequency of recurrence of the disease is usually reduced, although there is a possibility of recurrence. Over time, the frequency of symptoms may also decrease.
When should you see a doctor?
You should consult your doctor if you have symptoms of Meniere’s disease. Other diseases can also cause these problems, and it’s important to get an accurate diagnosis as soon as possible.
How is Meniere’s disease diagnosed?
Your doctor will do an exam and take a medical history. A diagnosis of Meniere’s disease requires:
- Two episodes of vertigo, each lasting 20 minutes or longer but not longer than 12 hours
- Hearing loss confirmed by a hearing test
- Tinnitus or a feeling of fullness in your ear
- Rule out other known causes of these problems
A hearing test (audiometry) evaluates how well you perceive sounds at different pitches and volume levels and how well you distinguish between similar-sounding words. People with Meniere’s disease typically have trouble hearing low frequencies or combined high and low frequencies with normal hearing in the mid frequencies.
Balance tests are done to test the function of your inner ear. People with Meniere’s disease have a reduced balance response in one of their ears.
The most commonly used balance test to test for Meniere’s disease is electronystagmography (ENG). In this test, electrodes are placed around your eyes to detect eye movement. Because the balance response in the inner ear causes eye movements.
During this test, both hot and cold water will be pushed into your ear. Water causes your balance function to work. Your involuntary eye movements will be tracked. Any abnormality may indicate a problem with the inner ear.
The swivel chair test is used less frequently. He or she will show your doctor if your problem is due to a problem in your ear or brain. It is used in addition to the ENG test because in some cases ENG results may be inaccurate. In this test, your eye movements are carefully recorded as the chair moves.
The vestibular evoked myogenic potential (VEMP) test measures the sound sensitivity of the vestibule of the inner ear. The posturography test helps you identify which part of your balance system is not working properly. You are expected to react to a variety of balance challenges while wearing a seat belt and standing barefoot.
Tests to rule out other conditions
Imaging scans, such as a blood test and magnetic resonance imaging , can be used to rule out disorders in the brain that can cause problems similar to Meniere’s disease, such as a tumor or multiple sclerosis .
How is Meniere’s disease treated?
There is no cure for Meniere’s disease. A number of treatments can help reduce the severity and frequency of vertigo attacks. But, unfortunately, there is no cure for hearing loss.
medicines for vertigo
Your doctor may prescribe medications to be taken during an episode of vertigo to reduce the severity of an attack:
- Motion sickness medications such as meclizine or diazepam can reduce the spinning sensation and help control nausea and vomiting.
- Anti -nausea medications such as promethazine can control nausea and vomiting during vertigo attacks.
Remember, your doctor will decide which medicine to take and how.
long-term drug use
Your doctor may prescribe a medication to reduce fluid retention and suggest that you limit your salt intake. For some people, this combination helps control the severity and frequency of Meniere’s disease symptoms.
Noninvasive treatments and procedures
Some people with Meniere’s disease may benefit from other noninvasive treatments and procedures, such as:
- Rehabilitation: If you have balance problems between episodes of vertigo, vestibular rehabilitation treatment can improve your balance.
- Hearing aid: A hearing aid in the ear affected by Meniere’s disease can improve your hearing. Your doctor may refer you to an audiologist to determine which hearing aid options will be best for you.
- Positive pressure therapy: For hard-to-treat vertigo, this treatment involves applying pressure to the middle ear to reduce fluid buildup. A device applies pressure pulses from the ventilation canal to the ear canal. You do the treatment at home, usually three times a day for five minutes at a time. Positive pressure therapy has shown improvement in symptoms of vertigo, tinnitus, and auditory pressure in some studies, but not in others. Its long-term effectiveness has not yet been determined.
If the conservative treatments listed above are not successful, your doctor may recommend some of the more aggressive treatments below.
middle ear injections
Medications injected into the middle ear and then absorbed into the inner ear can improve vertigo symptoms. This treatment is done in the doctor’s office. Available injections include:
- Gentamicin, an antibiotic toxic to your inner ear , reduces the balancing function of your ear and your other ear takes on the responsibility for balance. However, there is a greater risk of hearing loss.
- Steroids such as dexamethasone can also help control vertigo attacks in some people. While dexamethasone is slightly less effective than gentamicin, it is less likely to cause hearing loss than gentamicin.
If the vertigo attacks associated with Meniere’s disease are severe, debilitating, and other treatments do not help, surgery may be an option. Procedures include:
- Endolymphatic sac procedure: The endolymphatic sac is involved in regulating inner ear fluid levels. During the procedure, the endolymphatic sac opens, which can reduce excess fluid levels. In some cases, this procedure is combined with the placement of a shunt, which is a tube that drains excess fluid from your inner ear.
- Labyrinthectomy: With this procedure, the surgeon removes the balance portion of the inner ear, thereby removing both balance and hearing function from the affected ear. This procedure is only performed if you have a complete hearing loss in the affected ear.
- Vestibular nerve section: This procedure involves cutting the nerve in your inner ear that connects the balance and movement sensors to the brain. It usually corrects problems with vertigo while trying to preserve hearing in the affected ear. It requires general anesthesia and an overnight hospital stay.
Meniere’s disease exercises
There are some exercises that can help many people with this disease, these are:
- Vestibular eye exercises : These exercises include head and eye movements. You can do these exercises while sitting or lying down. First, sit in a chair or lie down on a bed. Try to look at your forehead and then look at your nose. Then look to the left as far as you can, and then to the right. Finally, hold your finger 3 inches away from your face, focus and slowly move your finger 1 inch away from your face while remaining in focus. Repeat this exercise as many times as you want, or ask your doctor for help designing a program.
- Seated vestibular head and shoulder exercises : To do these exercises, sit upright in a chair. First, tilt your chin towards your chest. Then lift your head back to look at the ceiling. Do this slowly and keep your eyes open. Keep doing this until you see it working. Next, look over your right shoulder and then slowly turn your head to look over your left shoulder. Like the bending exercise, do the head rotation exercise slowly.
- Aerobic activities : It is effective in walking, jogging, yoga, tai chi and sports balance training. Using cardio machines such as treadmills, elliptical bikes, stationary bikes, and skiers will not cure Meniere’s disease because they do not affect your balance. You can play racquetball, tennis, basketball, volleyball or any sport that interests you. Group exercise classes or attending a yoga or tai chi class are other things that come in handy. Daily exercise may be fine, but you should consult your doctor about how often and for how long you should exercise.
Meniere’s disease diet
With this disease, you can manage the most debilitating aspects of the condition with the right treatment, which usually includes diet and supplements. To manage this condition, a diet should focus on:
- Eliminating substances that cause the body to retain water
- Providing more diuretics to reduce fluid volume in the body
- limiting harmful substances that restrict blood flow
- limiting dietary supplements and common substances that worsen symptoms of Meniere’s disease
Water and diuretics
Water retention makes Meniere’s disease worse, but that doesn’t mean you have to stop drinking fluids. It’s more important to avoid liquids that contain large amounts of sugar and salt, such as fruit soda, mineral water, or concentrated juices that keep you hydrated.
Instead, drink the following fluids in moderation throughout the day:
- Low-sugar fruit juices
Diuretics are an important part of managing the disease. Diuretics are drugs that make the kidneys produce more urine, which reduces volume, salt levels, and fluid pressure in the body. These reductions help you better manage your condition. However, these drugs should be prescribed by your doctor.
Limit salt and sugar intake
Foods with a high sugar or salt content cause water retention, which can worsen the symptoms of Meniere’s disease. Sugar evokes an insulin response, and insulin retains sodium. Sodium causes the body to retain water. Try to avoid foods with simple sugar concentrations, such as:
- table sugar
- high fructose corn syrup
- Tea sugar
Instead of the above, focus on foods with higher levels of complex sugars, such as:
- Legumes, such as nuts, beans, and lentils
- Whole grains
- brown rice
The same rule applies to salt intake. Sodium is hard to cut back on because so much of our Western diet is full of salt. However, people with Meniere’s disease should aim for less than 2,300 milligrams of sodium each day, according to the Mayo Clinic . The intake should be spread evenly throughout the day. Much more than that will cause water retention.
Foods naturally low in sodium include:
- Fresh fruits and vegetables
- unprocessed grains
- Fresh meat, poultry and fish
Avoid alcohol, tobacco and caffeine
Caffeine should be avoided because it is a stimulant and can make tinnitus more severe. Caffeine and alcohol also interfere with its ability to regulate fluid levels, worsening the inner ear, causing headaches, pressure, and dizziness.
The nicotine in cigarettes and other tobacco products can make all symptoms worse by restricting blood flow to the inner ear. If you have Meniere’s disease, it is wise to avoid nicotine and tobacco.