Meniere’s Disease

Meniere’s disease is an inner-ear condition that can cause vertigo, a specific type of dizziness in which people feel as though they’re spinning. The most common symptoms are hearing loss, ringing in the ears, and pressure in the ear. It’s still not entirely clear what causes Meniere’s disease or how to cure it.

Meniere’s disease affects one out of every twenty thousand people worldwide and usually starts between the ages 20-50 with the onset of vertigo, hearing loss, ringing in the ears (tinnitus), head pressure (sometimes accompanied by pain). In most cases, only one ear is affected. The hearing loss brought about by Meniere’s disease can be eventually permanent.

Causes of Meniere’s Disease

Meniere’s disease is as old as time and doctors are still baffled by it. Symptoms of the condition can include vertigo, ringing in your ears, nausea, hearing loss and tinnitus. The cause of this illness is unknown but doctors have ideas about how the symptoms happen. To be more specific, they think that fluid builds up inside a part called the labyrinth which holds structures such as parts responsible for hearing and balance. This extra fluid interferes with signals to your brain causing vertigo and other ear related problems like hearing loss or tinnitus.

The reason why people get Meniere’s disease isn’t clear but researchers already have several strong theories pertaining to what affects the fluid of the inner ear. These include – 

  • Poor drainage (because of blockage or an abnormal structure in your ear)
  • Autoimmune response (when your body’s defense system attacks healthy cells)
  • Allergic reaction
  • Viral infection
  • Inherited tendency
  • Blow to the head
  • Migraine headaches

When it comes to Meniere’s disease, the symptoms may come alone or together.

Symptoms of Meniere’s disease

Meniere’s disease, which is a progressive condition, can start off gradually with occasional hearing loss. Over time it may worsen and lead to vertigo. If you are feeling dizzy, sit or lie down right away. Do not do any type of movement that might make your vertigo worse – such as driving.

Together with the main symptoms mentioned above, some people with Meniere’s disease may also experience the following:

  • Anxiety
  • Blurry vision
  • Nausea or diarrhea
  • Trembling
  • Cold sweat and rapid pulse

A headache is a common symptom of an attack. While it can last for as little as 20 minutes or up to 24 hours, it usually only lasts for about 10-12 hours after the initial onset. You might experience several attacks in a week, or you could go months without having one. Afterwards, you may feel exhausted and need to take some time to rest before doing anything too strenuous again.

As Meniere’s progresses, the symptoms may worsen and change. You could lose your hearing and have constant tinnitus. Balance problems or vision might become a problem instead of occasional bouts of vertigo.

If you think that you or a loved one may have Meniere’s disease, seek medical attention. It’s not wise to assume that this condition will go away or get better on its own.

Diagnosing Meniere’s Disease

When diagnosing Meniere’s disease, doctors will need to rule out symptoms and check the medical history. Below are some of the series of diagnostic tests that may be carried out to diagnose your balance and hearing:

Audiometric exam – Audiometric exams are available for those who would like to seek relief from any degree of hearing loss. It helps determine your ability to hear a range of sounds, with the use of a test that tests your speech discrimination within the left and right ears. Throughout the exam, our technicians will identify which sound pitches you are unable to receive well and what degree of deafness or imbalance needs attention.

Also take note: Audiometry is not just used by children in addressing delays in speech development but also by adults suffering from hearing loss, Ménière’s disease, Parkinson’s Disease, etc.

Electronystagmogram – This device can evaluate your balance and look for vestibular signs. You will be placed in a darkened room and have your eye movements monitored as cool and warm air is blown through your ear canal.

Electrocochleography – Electrocochleography measures fluid pressure in the inner ear and can be used to study benign positional vertigo. The procedure, usually performed by an ENT doctor (otolaryngologist), uses a special machine called a real-time, bedside diagnostic test for assessing consciousness.

Rotary chair testing – It’s not just the steady rotation that leads to dizziness with this test. The chair itself may be moving in back and forth or around swooping patterns while you sit strapped in, making it a workout for your eyes. 

Vestibular Evoked Myogenic Potentials (VEMPs) – a painless test for balance disorders. Literally hundreds of small muscles surround and protect the sensory organs in your inner ear from banging around loosely with every movement that you make, and produce tiny electrical signals – VEMP waves. These vibrations form patterns called action potentials in response to sounds or movements, that can be identified by sophisticated computer software as an easily measurable physical representation of the sense of balance.

VEMPs help doctors detect neurological damage or disease long before they would have any symptoms.

Posturography – Posturography is a simple, yet rigorous form of testing balance and stability. The platform moves in various ways to help the doctor identify any weaknesses or compensations patients may be using when their feet are missing from the ground. 

Video head impulse test (VHIT) – The video head impulse test is a quick and easy way to assess how well your vision responds when it’s forced to adjust to new images. The VHIT can identify various types of prescription errors for eyeglasses, diagnose neurological problems, evaluate brain injury or damage after an accident or during a medical procedure like surgery. 

Auditory Brainstem Response – The ABR test monitors your brainstem response to sounds in the ears. It measures what parts of the outer and inner ear you can use for hearing, how well you can hear different types of sounds, and whether or not there is a problem with either one. The exam is usually carried out without any sedation because no surgery will be performed as part of this test. It’s typically only used for people who couldn’t have other types of hearing tests (like babies) or who could not have imaging tests.

Doctors may also recommend a CT scan or an MRI to rule out any possibility that something else is causing Meniere’s disease and/or its symptoms.

Meniere’s Disease Treatment

Meniere’s Disease can be debilitating—that is, until you experience some of its treatments. We offer a variety of remedies to suit your needs and symptoms: from the effectiveness of hearing aids to treatments that help with vertigo and fluid buildup in the ears. 

Oral medications Meniere’s disease is a chronic, recurring form of vertigo, typically affecting one ear. Vertigo symptoms may come in waves or recur periodically. Meniere’s treatment focuses on controlling and preventing the dizziness and vomiting that often happen with this condition. There are many different types of medications that have been found to help with motion sickness, such as scopolamine patches, which can be worn behind the ear or mouth to prevent sea-sickness before it starts. Treatment also includes medication for nausea like antihistamines to control vomiting caused by motion sickness or other causes of dizziness.

Diuretics Lowering the amount of salt in your diet not only reduces fluid accumulation, but also decreases the frequency and intensity of symptoms. It has been found that reducing sodium consumption can reduce or even eliminate fluid accumulation while also decreasing kidney strain. 

Steroids Steroids can help to reduce inflammation in and around your middle ear. In some situations, taking steroids may be the best treatment for Meniere’s disease. If you or a doctor thinks that you have an underlying immune system problem such as hypothyroidism, lupus, Sjogren’s syndrome or sarcoidosis, steroids may be considered.

Therapies for Meniere’s disease

Physical therapy – We know how challenging it can be to manage Meniere’s symptoms. With Physical Therapy, the right exercise program can be combined with a tailored treatment plan that includes medication and other therapies to increase your quality of life. Professional guidance from someone who understands complex vestibular disorders is essential for patients managing their condition.

Vestibular rehabilitation therapy – Your doctor may recommend this therapy if you have balance problems due to lack of sensory input, such as balancing too much on one side. If VRT is recommended, a healthcare professional, such as an Occupational Therapist (OT) would customize a treatment plan for you based on how much weight your problem has caused to shift onto the opposite side and other factors. An OT will prescribe treatments that force your brain to receive sensory feedback from the senses it usually neglects. Relearning this information allows your brain to use these senses again.

Positive pressure therapy (Meniett device) – Therapy using Meniett device is an ear-based therapy that uses a device to apply pressure on the ear canal. This helps improve how fluid moves through the ear and can restore normal function more quickly for some people who suffer from dizziness, vertigo, or hearing loss. 

Surgery

A few patients won’t respond to any of these treatments and will need surgery. Those procedures  include Endolymphatic sac shunt surgery, Vestibular nerve sectioning, Cochleosacculotomy, Labyrinthectomy.

Meniere’s Disease Indiana

The first thing you should do if you think you are experiencing dizziness or vertigo is to see a doctor. There can be many potential causes and your doctor will have the most information to help determine what is going on with your ears. You should also make sure to stay hydrated and follow a healthy diet.

You don’t have to deal with Meniere’s disease alone. If you’re in Indiana, HearCare Audiology has a team of experts that can help you deal with hearing loss and other vestibular problems related to Meniere’s disease. Give us a call today!

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