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Meniere disease symptoms, causes, and treatment – Meniere’s disease

Meniere disease is an ailment of the inner ear affecting both the hearing and balance in your body. Here its symptoms, causes, and treatment.

This disease is a common cause of dizziness. Around 10% of all the cases of dizziness are due to MD. The definite reason for this disease is not fully understood yet. Even if not understood, it has around 15 new cases in every 100,000 people each year. It is most likely to affect people over 65 years old. However, almost anyone can have Meniere’s disease.

In the following reading, you’ll find the most frequently asked questions about Meniere’s disease. This includes the answers, directly from a doctor, that’ll help you understand a little better this condition. Don’t worry; all your doubts will be simply explained, from what is Meniere’s disease, to its diagnosis and treatment. 

What is Meniere’s disease?

Meniere’s disease is an ailment of the inner ear. You may also find it under the name of idiopathic endolymphatic hydrops.

The leading cause of this condition is the increase of the pressure in the endolymphatic system. To understand this condition, first, you need to know how the inner ear functions normally.

The inner ear is partially in charge of keeping your balance. It has three semicircular canals that widen to a structure called an endolymphatic sac. This is the membranous labyrinth.

Anatomy of the Ear. The outer ear is the auricle and ear canal through to the tympanic membrane. The middle ear contains the ossicles and is connected to the pharynx by the auditory tube. The inner ear is the cochlea and vestibule which are responsible for hearing and equilibrium, respectively.
Source

Inside the inner ear, you have the endolymph. It is fluid; therefore, it moves when you move. The movement makes this fluid move, stimulating hair cells in the inner ear.

These hair cells send signals that your brain interprets as a movement. Also, the endolymph helps transform mechanical signals into auditive signals.

On the other side, the endolymphatic system has two divisions: the perilymphatic and endolymphatic chambers. The perilymphatic chambers surround the endolymphatic chamber.

There is a membrane that separates both chambers: the vestibular membrane. In normal conditions, both chambers have perfectly balanced amounts of fluids. This is important to understand what happens in Meniere’s disease. 

What are the causes of Meniere’s disease?

Doctors don’t really know what causes Meniere’s disease. Yet, one thing is sure; it is an inner ear disorder.

Moreover, the mechanism is somewhat understood. The main cause is a fluid buildup in the inner ear. Because of unknown conditions, the endolymph increases.

When this happens, the balance between the number of fluids in the endolymphatic chamber and the perilymphatic chambers changes. This increase in the endolymph is what doctors know as endolymphatic hydrops.

This excess fluid can make the vestibular membrane stretch. When this happens, auditive symptoms like tinnitus and ear fullness may appear. This can keep happening until the vestibular membrane eventually breaks.

When it breaks, the liquid in the endolymphatic chamber and the perilymphatic chambers mixes together. This mix results in the symptoms of spinning and severe dizziness. 

Some conditions are thought to be linked to the development of Meniere’s disease. For example, it is common to find metabolic disturbances, hormonal changes, and inner ear traumas or infections between these causes. Especially viral infections are the ones related to this condition. Autoimmune diseases may be linked to this excess fluid too. 

Is menieres an autoimmune disease?

It is not clear yet. Doctors have found through many studies that a third of Meniere’s disease cases have an autoimmune origin.

There is a possibility that your immune system reacts abnormally and starts attacking your inner ear. This causes an inflammatory response, resulting in excess fluid in your inner ear.

However, the immunologic mechanism that causes this is not clear. Until there is further evidence, the doctor will consider autoimmune disease as a risk factor for MD. But, it is yet too soon to tell if it is, in fact, an autoimmune disease. Other autoimmune diseases, like lupus, can lead to fluid buildup that causes Meniere’s disease.

What are the risk factors for ménière disease?

We already know that the leading cause of Meniere’s disease is the fluid buildup in the inner ear. But, there are risk factors that can make you prone to develop this condition.

There are many risk factors for Meniere’s disease. First, it has a genetic risk. This means that if someone in your family has this condition, you are more likely to develop it.

Also, the fluid buildup may be the result of inflammation in the inner ear. Some diseases that cause inflammation, like viral infections, allergies, and autoimmune diseases, may also be a risk factor for MD. Specific conditions like migraines, head trauma, and blockage in the inner ear’s draining system may cause Meniere’s disease. 

What are the symptoms of Meniere’s disease?

Usually, the symptoms of Meniere’s disease come in sudden episodes of acute attacks.

The most common symptoms include: 

Vertigo

This is one of the most important symptoms. Vertigo is the sensation that you (or your head) are moving when you are not.

The vertigo attacks in Meniere’s disease usually last from a few minutes to 24 hours. This episodic vertigo may cause nausea or vomiting too. To consider vertigo symptoms, nystagmus has to be present.

Nystagmus is the involuntary eye movement when a vertigo episode occurs. This happens as a result of the inner ear stimulation. If the patient has severe vertigo, they can suffer sudden falls without losing their consciousness. 

Hearing loss: or sensorineural hearing loss, like doctors call it

This happens in the affected ear as a result of the excess fluid in the endolymphatic sac. A greater amount of endolymph makes it harder for the waves to travel along with the inner ear. Therefore, hearing capabilities will be impaired. In severe cases, it can become a permanent hearing loss. 

Tinnitus

This is a ringing sensation in the affected ear. Almost all of the affected individuals with Meniere’s disease will have tinnitus. This is also a result of the increased fluid inside the inner ear. Some patients describe it as an ocean-like roaring. Tinnitus can be intermittent or continuous. 

Aural fullness

This is the medical term to describe the sensation of your ear being full. It should seem obvious since what causes this is literally the accumulation of more inner ear fluid that there should be. 

Balance problems

Like other inner ear disorders, patients with Meniere’s disease may experience trouble with balance. They can also have headaches and nausea or vomiting due to severe vertigo.

What are the complications of Meniere’s disease?

One of the most dreaded complications of MD is deafness. Remember, this condition causes hearing loss, and, as a chronic and progressive disease, it can worsen over time.

This doesn’t mean you’ll go deaf, but there is a possibility. The sudden vertigo attacks of Meniere’s disease can make a person fall or faint and injure themselves. This loss of balance, if frequent, can make it harder for you to perform simple tasks. Head injuries after vertigo episodes are pretty common. 

If the patient experiences constant tinnitus, they’ll probably develop anxiety or insomnia. This is because of the constant humming inside your ear that can drive you crazy. 

How is Meniere’s disease diagnosed?

If you decide to consult your doctor about your symptoms, here’s how they will know if you have Meniere’s disease.

First, they’ll ask questions about your medical history. Then, they’ll ask about the symptoms you are having. Depending on your symptoms, your doctor will indicate some tests.

If you are experiencing hearing loss, your doctor can prescribe audiometry. In this examination, you will carry headphones and hear different noises. These noises will vary in pitch and sound. It is important for you to tell when you can hear and identify the noises.

Sometimes, you may be asked to differentiate from very similar sounds. This test will tell your doctor if you have hearing loss.

There is another test that can indicate to your doctor if you have hearing loss. It is the electrocochleography, and it measures the electrical activity of the inner ear. Your doctor can tell if the problem is your inner ear or your ear nerve with this test. 

Your doctor may want to perform a balance test too. One of the balance test doctors perform for Meniere’s disease is the electronystagmography. In this test, your doctor will put electrodes around your eyes. This is to detect nystagmus or involuntary eye movement.

Then, the doctor will push hot and cold water in each ear. The purpose of this is to stimulate your balance function. If nystagmus appears during this test, an inner ear disease should be considered.

In some cases, your doctor may indicate imaging tests. A CT-scan or an MRI are great tools to out rule other brain conditions that cause vertigo. 

Does Meniere’s disease go away?

Unfortunately, no. Meniere’s disease is a continuous and progressive condition. 

This means that it will get worse over time. There is no definite cure for it. Even with treatment, you will not stop having Meniere’s disease.

The important thing is to keep the symptoms as mild as possible, and the vertigo attacks less frequent. However, patients may experience periods with fewer symptoms or no symptoms at all.

These periods of remission are variable in duration. There is no way to know if you will eventually have a remission period or how long it will last.

If you are lucky, remission periods can last even for months or years. Typically, patients can have remission of one or two symptoms. Most patients with Meniere’s disease say that vertigo declines with time, but tinnitus and hearing loss persists. 

What is the treatment for Meniere’s disease?

Remember, Meniere’s disease is a chronic condition. It is progressive, meaning that it will most likely worsen over time. However, there are a few therapeutic approaches that can help with the symptoms. 

Medication

Medication is not the most helpful tool. However, some medication is used to help with severe symptoms like nausea or vomiting. In these cases, your doctor may prescribe you some anti-nausea or antiemetic drugs.

Some patients benefit from the use of diuretics because it helps with fluid excess. This relieves ear pressure and makes symptoms milder. Some other patients will get better with a steroid injection right in the inner ear. This way, the inflammation is reduced. 

Diet

Since the problem in Meniere’s disease is the excess of fluid; diet changes can be helpful. Reducing your salt, caffeine, and alcohol intake can be a way of having milder symptoms. 

Surgery

If everything else fails, your doctor may recommend surgery. However, these surgical procedures may have permanent side effects.

One of the procedures is the endolymphatic sac decompression surgery. Here, your doctor will remove the bone that surrounds the endolymphatic sac. This makes that the fluid can flow out of the endolymphatic sac, helping decompress.

Another endolymphatic sac surgery puts a clip to block the fluid’s passage from the sac to the inner ear. If the vertigo is still present after these procedures, your doctor has another alternative.

By cutting the balance nerve, or vestibular nerve, your doctor can stop the vertigo episodes. This procedure’s name is a vestibular neurectomy, and it eliminates the signals of movement to go to your brain.

Minett device

It has been proven as a benefit to patients with MD. This device goes inside your inner ear and applies extra pressure. This way, it helps with the endolymph flow, preventing the accumulation of liquid in the endolymphatic chambers. 

Vestibular rehabilitation

It is a group of exercises designed to help with balance and vertigo episodes. Many patients benefit from this method. At times it is the only treatment they need. However, in severe cases, it can be a part of the pre or post-surgery plan. 

Do you think you have Meniere disease?

This is a Meniere Disease Symptoms Checker. It gathers the most important signs, symptoms, and risk factors for this disease. Therefore, the tool tells anybody who uses the likelihood that their symptoms are because of Meniere Disease. It is free and would only take a few minutes.

What do you think?

Written by Dr. Esteban Kosak

Doctor of Medicine - MD Recently Graduated from Medical School and inspired to aid the global population during this situation. I think that we shall no longer be waiting to see a doctor when we feel sick. Several times we feel disease searches in Google drive us to a rabbit hole and come out thinking that we may die of cancer or something very serious, given that symptoms may seem to fit a wide variety of illnesses. Since I recently graduated from medical school. I have all the medical information fresh in my mind. My thorough experience as an expert researcher allows me to very-well known the different diseases and conditions that affect human bodies. Empowered by the United Nations 17 Sustainable Development Goals (SGDs). I think that we all can provide a grain of sand to help humanity. That's why we created Symptoms.Care a place where you can come and screen your symptoms and find what different illnesses can be related to them. Armed with the right information you can instantly, discretely, secure and from the comfort of your home talk with a Doctor that can Evaluate your Symptoms and help you seek the right treatment.

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