Meniere’s disease, an inner ear disorder causing vertigo and hearing loss among other symptoms, was first described by a French physician in 1861, according to the National Institute on Deafness and Other Communication Disorders, or NIDCD. The NIDCD estimates that in the United States, about 615,000 people currently suffer from Meniere’s disease.
Symptoms
People with Meniere’s disease suffer from episodes of vertigo, a sensation that you or your surroundings are spinning or wheeling around, even if you stay perfectly still. Unlike in benign paroxysmal positional vertigo, the most common cause of vertigo, with Meniere’s disease the episodes of vertigo occur spontaneously and episodically, lasting from 20 minutes to two hours, according to MayoClinic.com. Along with vertigo, during an attack, people with Meniere’s disease might also experience ringing in the ears, a feeling of fullness or pressure in the ears, nausea or diarrhea, and some degree of hearing loss. Although hearing recovers between episodes, over time it deteriorates.
Cause
Symptoms of Meniere’s disease arise from a malfunction in the volume or pressure of endolymph, the fluid normally found in the membranous labyrinth of the inner ear. In a healthy ear, movement of the head causes the endolymph to move like water in a tilted glass, triggering hair-like sensors that send a signal to the brain to maintain correct spatial awareness and balance. If the volume or pressure of endolymph rises, the sensors can fire without head movement. The brain receives false information, resulting in the sensation of vertigo.
Expert Insight
As outlined by the NIDCD, some experts believe that Meniere's disease arises when endolymph leaks out of the membranous labyrinth to mix with perilymph, a fluid from the space between the membranous labyrinth and the bony labyrinth. With fluid mixing, the brain receives erroneous signals that trigger episodes of vertigo. In this theory, the mixing results from noise pollution, viral infection or biological factors that rupture the membranous labyrinth.
Diagnosis
A doctor diagnoses Meniere’s disease after excluding other possibilities and determining a patient history of at least two attacks of vertigo of a minimum of 20 minutes' duration along with symptoms of tinnitus and aural pressure (a feeling of fullness in the ear), and verifying hearing loss with a hearing test. An MRI can rule out the possibility of an acoustic neuroma or vestibular schwannoma, a benign tumor on the nerve connecting the inner ear to the brain, which can produce vertigo and other symptoms similar to those of Meniere’s disease.
Treatment
Meniere’s disease has no cure, but lifestyle changes or medical treatment can reduce the severity of the symptoms, especially the vertigo. Measures to reduce the fluid retention and pressure in the inner ear can help. Such measures can include following a low-salt diet; avoiding caffeine, tobacco and alcohol; or taking certain medications. For persistent and debilitating vertigo, patients might want to consider surgery or injection of the antibiotic gentamycin into the middle ear space to deaden the nerve.
