Meniere’s Disease

Written by Medicine and Health. Posted in Disease, Condition & Injury, Ears, nose & throat, Head & neck conditions

Meniere’s disease – Definition

Meniere’s disease is a disorder of the labyrinth in the inner ear. The labyrinth is a system of cavities and canals in the inner ear that affects hearing, balance, and eye movement.

Meniere’s disease – Causes

An increase in the volume or pressure of fluid in the labyrinth can result in Meniere’s disease. The cause of these fluid changes is unknown. Possible causes may include:

  • Part of the labyrinth ruptures, allowing fluid in different compartments to mix
  • Scar tissue causes a blockage in the labyrinth
  • Inner ear injury due to:
    • Viral infection
    • Syphilis, a sexually-transmitted disease
    • Autoimmune disorders
    • Blood vessel problems
    • High cholesterol or other fats in the blood
    • Hormonal disorders
    • Medications, such as antibiotics and chemotherapy agents

Meniere’s disease – Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Risk factors for Meniere’s disease include:

  • Age: 20 to 60
  • Race: Caucasian
  • Family history of Meniere’s disease
  • Stress
  • Allergies
  • Excess salt in the diet
  • Excess noise

Meniere’s disease – Symptoms

The intensity of symptoms can vary from one person to another. Symptoms usually come on suddenly. They typically involve only one ear, but may involve both.

  • Symptoms may include:
  • Episodes of vertigo (spinning sensation), often accompanied by:
    • Nausea or vomiting
    • Sweating
    • Paleness of the skin
    • Weakness or falling
    • In some cases, headache or diarrhea
  • Hearing loss may worsen during attacks of vertigo
  • Tinnitus (ringing in the ears)
  • Feeling of fullness or pressure in the ear
  • Poor sense of balance
  • A tendency for symptoms to worsen with movement

Meniere’s disease – Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. This will include an examination of your ears and a neurologic exam to evaluate for possible nerve damage.

Tests may include:

  • Blood tests — to check for an underlying cause
  • Hearing test — this is also called an audiometry
  • Electronystagmogram — a type of eye movement test
  • Auditory brainstem response — measures electrical activity in the hearing nerve and brain stem
  • Electrocochleogram — measures electrical response of the inner ear to sound
  • MRI scan — a test that uses magnetic waves to make pictures of structures inside the ear

Meniere’s disease – Treatment

Treatment may include:

Dietary and Lifestyle Changes

These may help limit symptoms:

  • Bed-rest during acute attacks of vertigo
  • Avoid foods that are high in salt and high in sugar
  • Drink adequate fluids
  • Promptly begin replacing fluids lost to heat or exercise
  • Avoid caffeine, aspirin, and smoking
  • Minimize stress
  • Avoid medications that seem to bring on or worsen symptoms
  • Consider a hearing aid, if necessary
  • Consider masking devices (white noise) to limit the effects of tinnitus
  • Take safety measures to avoid falling
  • Restrict chocolate consumption
  • Reduce alcohol intake

Vestibular Exercises (Vestibular Rehabilitation)

Your doctor may suggest specific vestibular exercises. These exercises use a series of eye, head, and body movements to get the body used to moving without dizziness. You may work with a physical therapist to learn these.

Medications

Medications include:

  • Drugs to treat vertigo, such as meclizine or scopolamine
  • Antiemetics — medications to help control nausea
  • Other medications that may improve hearing, control inner ear swelling, or limit overall symptoms, including:
    • Antihistamines
    • Cortisone drugs for a short time
    • Antidepressants or anti-anxiety medications
    • Diuretics
  • Aminoglycoside therapy (such as streptomycin or gentamicin) to permanently destroy the part of the inner ear that deals with balance

Surgery

Surgical procedures are not always helpful, and include:

  • Endolymphatic sac decompression — removal of a portion of inner ear bone and placing a tube in the inner ear to drain excess fluid
  • Labyrinthectomy — destruction or removal of the entire inner ear, which controls balance and hearing
  • Vestibular nerve section

Meniere’s disease – Prevention

There are no specific guidelines for preventing Meniere’s disease. However, to help reduce your risk, avoid the following risk factors:

  • High-salt diet
  • High-sugar diet
  • Excess noise
  • Excess alcohol
  • Stress
  • Smoking
  • Use of drugs that can be toxic to the ear such aminoglycosides, aspirin, and quinine

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