Ménière’s Disease

            Ménière’s disease is a disorder of the inner ear that affects hearing and balance. It is a chronic condition that can have a significant impact on a person’s quality of life. The disease is relatively rare, affecting an estimated 0.2% of the population, and it is more common in middle-aged adults. The exact cause of Ménière’s disease is not known, but it is thought to be related to a problem with the fluid in the inner ear. The fluid is responsible for maintaining the balance of the ear and the perception of sound. When there is an abnormal buildup of fluids in the inner ear, it can cause symptoms such as vertigo, permanent hearing loss (one ear), and tinnitus. 

Symptoms:

            People dealing with Ménière’s disease experience episodes that may last from a few minutes, up to a few hours. During these episodes, they can encounter a variety of symptoms. The most common symptoms are vertigo, tinnitus, nausea, migraines and fullness in the ears. These symptoms can be debilitating, making it difficult to perform daily activities and can even lead to anxiety and depression. There is no indication as to when an episode may occur, as they happen sporadically with no warning.   An episode of Ménière’s disease is exhausting and causes patients to experience fatigue up to a few days after.

            Vertigo is the most common symptom of Ménière’s disease and it is the sensation that you, or the environment around you is moving or spinning. This feeling may be barely noticeable, or it may be so severe that you find it difficult to keep your balance and do everyday tasks. Tinnitus, which is a ringing or buzzing in one or both of the ears can make hearing loss seem worse during an episode. Both vertigo and tinnitus can lead to nausea or migraines.

           While symptoms of Ménière’s disease can vary from person to person, one telltale sign that affects all patients is permanent hearing loss in just one ear. Low frequency sounds are the first to deteriorate, but over time the high frequency spectrum can be affected as well. 

Diagnosis:

           The diagnosis of Ménière’s disease typically starts with a thorough examination of the patient’s medical history, including symptoms and any other conditions that may be related to the disease.  The next step is to see a Hearing Specialist, where a series of tests such as an audiogram is performed. This test will assess for hearing loss on both high and low frequencies. This test may even indicate how far along the condition is. Another test performed during a hearing test is a tympanometry test, which will test the pressure in the ears. 

           A doctor will perform a vestibular function test to evaluate balance and determine the severity of vertigo. An electronystagmography (ENG) is used during an episode vertigo, as it  measures eye movement and gives healthcare providers more information about inner ear function and nerves.  These tests can help to confirm the diagnosis of Ménière’s disease and also rule out other conditions that may have similar symptoms. 

Treatment:

          There is no cure for Ménière’s disease, but there are a number of treatment options that can help manage symptoms. They can vary, depending on the severity of the condition, and the symptoms that the patient is experiencing.

          In mild cases, lifestyle changes may be enough to manage symptoms. Finding ways to reduce stress, avoiding triggers that can bring on an episode of vertigo, and making dietary changes to avoid high sodium foods that may aggravate symptoms are all great ways to improve the probability of an episode.

          In all cases, the hearing loss can be treated with the use of hearing aids to improve the patient’s ability to hear, and can help treat tinnitus, associated with hearing loss. 

          Medications, such as antihistamines, are used to control vertigo and nausea. Diuretics help to reduce fluid buildup in the inner ear, and anti-anxiety medications may also be prescribed to reduce stress. Another treatment option that has shown to be successful is regular adjustments from a chiropractor. This helps to restore the proper flow of spinal fluid in your inner ear, which can alleviate the dizziness and vertigo that accompanies Ménière’s disease. In more severe cases, surgery may be necessary to remove the fluid that is causing the pressure in the inner ear.  

Who is at risk?

         There are a few risk factors for Ménière’s disease. These include people of the age of 40, a family history of the condition, head injuries, and certain viral infections. It is also more common in people with certain medical conditions, such as migraines, hypertension (high blood pressure), autoimmune diseases and allergies. 

          Ménière’s disease is a chronic condition that affects hearing and balance. Although it is not fully understood or curable, there are some treatment options to manage the symptoms of the debilitating disease. If you are experiencing vertigo, tinnitus or hearing loss, get a hearing test done to help understand if there is something more serious going on.