Brain Facts

Brain Facts

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Meniere's Disease

Description

In 1861, French physician Prosper Meniere described a condition that now bears his name. Meniere's Disease (MD) is a disorder of the inner ear associated with a change in the volume of fluid inside a portion of the inner ear called the labyrinth, which includes the membranous and bony labyrinth. It causes episodes of vertigo, tinnitus (a constant noise in one ear, often described as a buzzing or humming sound), a feeling of fullness or pressure in the ear, and fluctuating, progressive  low-frequency hearing loss.

A typical attack of Meniere's disease may be preceded by fullness or aching in one or both ears. Hearing fluctuation or tinnitus may also precede an attack. A Meniere's episode generally involves severe vertigo (spinning), imbalance, nausea, and vomiting. The average attack lasts two to four hours. After a severe attack, most people find that they are extremely exhausted and must sleep for several hours.

In some people, Meniere's episodes may occur in clusters; that is, several attacks may occur within a short time. In other cases, weeks, months, or even years may pass between episodes. Between the acute attacks, most people are free of symptoms or note only mild imbalance and tinnitus.

In most cases, Meniere's disease is confined to one ear. Frequently, hearing in the affected ear(s) is progressively lost.

Diagnosis is difficult because other conditions present some of the same symptoms, so diagnostic testing is critical, including radiological studies.

The incidence of Meniere's disease has been estimated to range from 0.5 to 7.5 per 1000, although this figure depends upon a number of factors, such as the diagnostic criteria used to define the disease. It also varies by ethnic background, showing relatively high incidence in Britain and Sweden. Meniere's disease most commonly affects people in their 40s and 50s, although individuals from 20 onwards may be affected. It is rarely, though occasionally reported in children. Males and females appear to show a similar incidence of Meniere's.

Several recent studies describe women's increasing anecdotal reports of symptom exacerbation during the perimenstruum (from ovulation through the menstrual bleed). To date, however, no studies have carefully explored women's symptom reports to establish the relationship between menstrual cycle phases and Meniere's disease responses.

Some sufferers report that attacks appear to be related to stress, but again no  causal relationship has been established.

There does not appear to be any evidence for MD being a hereditary disease.


Treatment

There are an extremely large number of treatments presently being used to treat Meniere's disease. (This is perhaps a reflection of the fact that no single treatment is effective in all patients.) They include:

Dietary changes such as restricting the intake of salt, water, caffeine, chocolate or alcohol
Medications including diuretics (drugs to reduce fluids), anti-emetics, anti-nausea, anti-vertigo and anti-anxiety drugs, steroids, and anti-histamines
Nutritional supplements such as ginko biloba, ginger, and lipoflavinoids
Surgical procedures which either cut the balance nerve or drain fluid from the inner ear.


Prognosis

There is no cure for Meniere's Disease. Meniere's Disease cannot be treated and made to "go away" as if you never had it. It is a progressive disease which worsens, more slowly in some and more quickly in others. Some patients experience periods of remission (absence of some or all symptoms) for no apparent reason. Some remissions may continue for many years; even decades. Other remissions are short-lived.

Although the attacks of vertigo may decline with time, the hearing loss and tinnitus generally persist.

Many people suffering from MD lead productive, near-normal lives; others face greater challenges in coping.

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