Symptoms
Menière’s disease is a condition that affects the fluid balance of the inner ear. What you need to know in this context is that the inner ear consists of the organ of equilibrium and the organ of hearing (cochlear). Both organs have semicircular canals filled with liquids. When patients suffer a Menière’s attack, however, these canals overfill, resulting in serious problems for the inner ear. The three classic main symptoms of Menière’s disease are:
- Severe rotary vertigo lasting from a few minutes to several hours
- Deafness (particularly in the deep tone range and most often, on one side only)
- Tinnitus
However, the disease also causes several side effects such as:
- Ear pressure
- Nausea and vomiting
- Severe sweating
- Trembling of the eye (Nystagmus)
Menière’s disease most frequently develops in patients between the ages of 20 and 50 and usually only affects one ear. If the condition persists for a long time, however, the chances that it will also affect the other ear, increase. Due to the long-lasting rotary vertigo many patients suffer from nausea that can even result in vomiting. Their consciousness, however, remains unaffected during the attacks. This sometimes results in a spiral of fear in patient’s suffering from Menière’s disease: They are afraid of suffering another attack which makes them feel stressed. Thus, the psychological aspect of Menière’s disease must not be underestimated. Days, weeks, months and even years can pass between individual attacks. On a positive note, the number of rotary vertigo attacks often decreases during the course of the disease.
Causes
The precises causes of Menière’s are unknown, but we have a few ideas. One possible cause, for instance, lies in a rupture of Reissner’s membrane, a thin cell membrane inside the cochlear in the inner ear. When this membrane ruptures, a liquid (potassium-poor perilymph) exits, increasing the pressure in the cochlear of the affected ear. Viral infections causing an inflammation of the inner ear are suspected to be another likely culprit.
Consult an audiologist as dizziness, tinnitus and hearing loss can also be caused by other conditions and are not always attributable to an attack of Menière’s.
Diagnosis
If these symptoms sound familiar to you, you should quickly consult an audiologist. The audiologist will run several tests to diagnose Menière’s disease and identify possible causes. Since dizziness is one of the typical symptoms, your audiologist will also test the organ of equilibrium and eyes.
To determine whether the Menière’s attack was caused by other conditions, the doctor will furthermore discuss your medical history with you.
Treatment
Based on current knowledge, Menière’s disease is regarded as incurable. To this day, it has not been conclusively proven what causes the disease. Its symptoms can, however, be treated with medication and/or operations. We distinguish between two measures that are supposed to prevent further attacks and acute treatment during an attack. To treat the related dizziness, patients are given anti-vertigo drugs (anti [gr.] = against, vertigo [lat.] = dizziness). Since their dizziness often causes severe nausea, Menière’s patients are also prescribed anti-nausea drugs.
Other methods are used on patients who suffer from particularly severe cases of Menière’s disease and have lots of fits of dizziness.
One option is to prescribe drugs (gentamycin) to deactivate the organ of equilibrium which might put an end to the patient’s fits of dizziness. However, this could adversely affect the patient’s hearing.
Furthermore, there are several surgical procedures. In some cases, the patient’s balance nerve is severed by means of a surgical procedure (neurectomy) which puts a permanent end to dizziness. Another form of treatment is a saccotomy during which pressure is relieved by means of a tiny opening being poked into a part of the inner ear.