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Ménière Disease

Ménière Disease

Ménière disease is a syndrome in which you experience episodes of spinningvertigo (sense of the room spinning), hearing loss, and tinnitus (ringing in the ear). Between the unpredictable attacks, you usually do not have any problems or symptoms of the disease.

 

Ménière disease was first described in 1861 by the French physician Prosper Ménière. Yet the cause of this syndrome still remains largely unknown.

 

The diagnosis of the disease is usually based on a careful history and physical examination by a doctor, but other tests may be needed for a definitive diagnosis and to plan treatment options.

 

Ménière disease affects people of all ages, especially those of middle age or older. It is, however, uncommon in children.

Symptoms

Warning symptoms such as fullness or pressure in one ear may come before an acuteepisode of the disease, or attacks may occur spontaneously.

 

Common symptoms are these: 

 

  • Fluctuating hearing loss with distortion of sounds and difficulty with speech discrimination.
  • Ringing in the affected ear (tinnitus).
  • A sense of the room spinning (vertigo).
  • A cold sweat, nausea and vomiting, or generalized weakness during the attack.

 

The episodes are unpredictable and usually last from 1 hour to a few hours, depending on the severity of the disease. 

 

Recurrence of the attacks is a cardinal feature of Ménière disease. Typically the attacks are few, but the usual pattern of Ménière disease is increasing frequency and severity of the symptoms. The disease can be very disabling as the frequency and severity of the attacks increases. 

 

Early in the disease, the symptoms usually go away in several hours, but hearing loss may take a day or more to return to normal. Hearing loss can become permanent and, due to changes in the middle ear, may lead to intolerance of any loud noises.

Causes

The most common causes of the disease are still unknown. It is suspected that food allergymay play a part. Some suspect that Ménière disease is the response of the inner ear to injury. In any case, if someone in your family has it, you are at higher risk for developing it.

 

Although the cause of Meniere's disease is unknown, it probably results from an abnormality in the way fluid of the inner ear is regulated. In most cases only one ear is involved, but both ears may be affected in about 10% to 20% of patients. Meniere's disease typically starts between the ages of 20 and 50 years of age (although it has been reported in nearly all age groups).

 

Men and women are equally affected. The symptoms may be only a minor nuisance, or can become disabling, especially if the attacks of vertigo are severe, frequent, and occur without warning. Meniere's disease is also called idiopathic endolymphatic hydrops.

Treatment

The best way to manage an attack at home is to minimize the symptoms.

 

Lie in a quiet room with your eyes closed. Try medications prescribed by your doctor: Medications that help decrease anxietysuch as diazepam (Valium) orprochlorperazine (Compazine) can be used to help shorten and decrease the severity of the symptoms. Your doctor can prescribe these types of medications and others after a complete evaluation and treatment plan is made. 

 

If these treatments do not help during an attack, seek further medical evaluation for other treatment options. Rule out any other potential diseases.

 

The decision to manage Ménière disease medically or surgically should be made with your doctor in order to get the best results from treatment options available. 

 

Most acute attacks are managed conservatively at home, or with medications prescribed by your doctor such as diazepam (Valium), which decreases anxiety, and meclizine (Antivert), which decreases the spinning sensation. Other medications are available but typically require evaluation by an ear, nose, andthroat specialist for use. 

 

Long-term management of Ménière disease is aimed at reducing the frequency and severity of the spells. A diet low in salt may help. So medications that decrease thesodium load (diuretics) may be prescribed by your doctor.

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