Meniere’s Disease is one of the trickiest vestibular disorders because so little is confirmed about its cause, its signs, and its treatment. This makes it particularly difficult for people to cope with and find help for Meniere’s.
But fear not, because methods exist for diagnosing and treating Meniere’s Disease. While there isn’t a cure, there are ways to rehabilitate patients after a Meniere’s attack and alleviate the symptoms in the future.
Meniere’s Disease Symptoms
According to The National Institute on Deafness and Other Communication Disorders (NIDCD), approximately 615,000 individuals in the United States have a Meniere’s Disease diagnosis. And doctors diagnose about 45,500 new cases each year.
Symptoms of a Meniere’s attack:
- A typical episode starts with fullness in one ear, hearing fluctuations, and tinnitus.
- It also includes severe true rotational vertigo, nausea, and vomiting.
- An episode typically lasts between two to four hours.
- Exhaustion follows the attack and most people sleep off the experience.
Many Meniere's patients find the symptoms debilitating. Meniere’s Disease symptom fatigue is a common occurrence where patients’ quality of life drops because the symptoms are so draining.
What Causes Meniere’s Disease?
The origin of Meniere's disease is highly debated. As we established, aural fullness (the feeling that your ears are full) is a marker for Meniere’s Disease. Scientifically, this is called endolymphatic hydrops.
How the fluid moves in your hearing and balance structures of the inner ear dictate part of your balance. Those with Meniere’s have abnormal fluctuations in the fluid (called endolymph). Your ears feel full because they are full of endolymph.
What does aural fullness have to do with the cause of Meniere’s Disease?
In the past, researchers felt that aural fullness caused the disease. But the most current opinion is that hydrops is just a sign of Meniere's Disease – rather than the cause.
Other theories on the cause of Meniere’s Disease include constriction of blood vessels (similar to the cause of migraines), an autoimmune reaction, a genetic connection, migraine, and viral infection. However, there’s still no consensus on the cause.
Additionally, Ménière’s Disease develops at any age. But, it is more likely developed in adults aged 40 to 60 years.
How Is It Diagnosed?
With no clear cause of Meniere’s Disease, diagnosing it relies on analyzing your symptoms and ruling out other vestibular disorders. Therefore, Otolaryngologists (also known as ENTs) or Vestibular Audiologists are the most well-suited doctors for diagnosing Meniere’s Disease.
We diagnose Meniere’s based on your medical history and the combination of:
- Two or more episodes of vertigo lasting at least 20 minutes each
- Fluctuating and progressive hearing loss
- A feeling of fullness in the ear
Additionally, we run dizzy patients through the following testing procedures – analyzing any problems in the vestibular system:
- Hearing testing with audiometry, tympanometry, otoacoustic emissions,
- Electrocochleography (ECOG)
- Videonystagmography (VNG)
- Rotational chair
- Video head impulse testing (VHIT)
- Vestibular-evoked myogenic potentials (VEMP)
Additionally, the doctor may run blood tests and MRIs of your brain and internal auditory canals.
Unfortunately, doctors commonly misdiagnose Meniere’s Disease. This is because many other conditions share similar symptoms. Therefore, it is paramount to go to well-equipped ENTs or Vestibular Audiologists.
Meniere’s Disease has a variety of possible treatments. Ultimately, the goal is seeing what works and then doubling down. Dietary changes are the most universally effective treatments. Read about Meniere’s Disease Diet here.
Meniere’s treatment options include:
- Lifestyle Changes: Limiting caffeine, chocolate, alcohol, and salt, has been effective in reducing vertigo attacks. Patients diagnosed with Ménière's disease are typically counseled to adopt a low-salt diet (1,500–2,000 mg per day), and some are also started on a diuretic.
- Steroid Therapy: Steroid therapy has also been utilized for the treatment of symptoms associated with Ménière's disease, especially in patients with a sudden decrease in hearing.
- Vestibular Rehabilitation Therapy (VRT): Can be helpful with the lingering imbalance between attacks. The goal is to retrain the ability of the ears, eyes, muscles, and brain to process balance information correctly. Therapy can assist in regaining confidence with head and body movements. (More info on VRT here)
- Surgery options: Within the last 10 years, surgical options have expanded to include minimally invasive inner ear chemical perfusions and endolymphatic sac decompression (ELS).
It’s worth mentioning that sometimes people will find ways to lessen their symptoms on their own through one of the many Strategies for Coping with Meniere’s Disease.
The NIDCD estimates that 60% of people improve on their own or by controlling their diet, drugs, or devices. However, a small group of people with Ménière’s disease will get relief only by undergoing surgery.
Overall, if you have more questions about Meniere’s Disease, then head over to this article on Answering 14 Common Meniere’s Disease Questions. In it, we cover everything from how to work and travel with Meniere’s Disease to the relationship between seasonal allergies and Meniere’s flare-ups.
If you’re tired of living with Meniere’s and are ready to seek treatment, then we advise you to reach out to our clinic, the Dizzy & Vertigo Institute of Los Angeles. We specialize in diagnosing and treating vestibular disorders and have a great track record of helping people get back to a dizzy-free life.
Please reach out to our care team by filling out our contact form or giving us a call at (310) 954-2207.
We are looking forward to helping you!