Meniere’s disease affects the inner ear, which is the centre of hearing and balance. During an attack, the person experiences vertigo – a sensation that they or the world around them is moving. They feel dizzy and sick, their hearing is dominated by a hissing or roaring sound (tinnitus), and one or both ears feel full to bursting point.Meniere’s disease may develop slowly over time, with a gradual loss of hearing, or suddenly with a vertigo attack. Attacks can last from 10 minutes to several hours.
After an attack, the person might experience mild deafness and feel unsure of their footing. As the disease progresses, the episodes of vertigo become less frequent and the deafness more severe.
It is thought that Meniere’s disease is caused by a build-up of fluid inside the inner ear. This interrupts messages to the brain from both the balance and the hearing nerves, causing loss of control of these functions.
A diagnosis of Meniere’s disease includes vertigo, hearing loss, tinnitus and a feeling of pressure. Many of the symptoms of Meniere’s disease can also be caused by other conditions, so diagnosis of the condition often involves first ruling out other medical possibilities.
There is no specific test for Meniere’s disease, but doctors use a range of tests in combination to help diagnose the disorder. These include:
- Hearing tests – to test if hearing loss is specific to your inner ear. Low frequency loss is an indicator of Meniere’s
- Brainstem evoked responses and electronystagmography (ENG) – are neurophysiological measures nerve function affecting balance and involuntary eye movements
- Magnetic resonance imaging (MRI) – may be used to rule out disorders of the central nervous system that may be confused with Meniere’s disease, such as acoustic neuroma, Arnold-Chiari malformation and multiple sclerosis (MS).
There is no cure for Meniere’s disease. Treatment generally focuses on managing symptoms and preventing or decreasing the number of attacks. Where possible, the aim is to conserve hearing and reduce balance problems.
Non-surgical options include:
- Medication – to control vertigo, nausea and vomiting, and reduce anxiety and fluid retention
- Lifestyle changes – stress management, dietary changes, especially a low-salt diet, and quitting smoking
- Pressure pulse devices – to help relieve the build-up of pressure and reduce vertigo for people whose symptoms do not respond to medical therapy
- Chemical ablation – an antibiotic is used to reduce or destroy the remaining balance (vestibular) functions of the inner ear, so that signals are no longer sent to the brain.
If you are experiencing severe attacks of vertigo and medical treatments don’t help, surgery may be considered as a last resort. This may include procedures that:
- Alter the build-up of fluid in your inner ear (endolymphatic sac procedures)
- Destroy the balance mechanism of the inner ear (vestibular nerve section or vestibular neurectomy) – these are serious operations that carry a risk of hearing loss, can temporarily disrupt your balance and may require a period of rehabilitation.
Information adapted from: www.betterhealth.vic.gov