Meniere's disease (Ménière's disease) is a condition with vertigo, tinnitus (ringing, buzzing, noises in the ears) and progressive deafness. There is no cure, but there are some treatments that can ease the condition.
It is estimated that approximately 1 in every 1,000 people suffers from Meniere's disease. The disease can develop at any age, but more commonly does so when the patient is aged between 40 and 60.
According to the National Institute of Deafness and Other Communication Disorders, approximately 615,000 people in the US have the disease.
In this article, we will look at the causes, symptoms, treatment and complications of Meniere's disease.
Contents of this article:
Fast facts on Meniere's disease
Here are some key points about Meniere's disease. More detail and supporting information is in the main article.
- Meniere's disease involves dysfunction in the inner ear
- To date, there is no cure for Meniere's disease
- The symptoms include vertigo, dizziness, nausea and a progressive loss of hearing
- Rarer symptoms include anxiety and depression
- The exact causes of Meniere's disease are not known
- There are no tests for Meniere's disease, so a doctor will discuss symptoms and patient history to reach a diagnosis
- Individuals with Meniere's disease will have their hearing and balance checked
- Although there is no cure, certain drugs can ease the symptoms, such as Valium or Maxzide
- Meniere's disease rarely effects both ears
- Sometimes, small dietary changes can have a positive impact on the symptoms of Meniere's disease.
What is Meniere's disease?
The disease is named after Prosper Meniere (1799-1862), a French physician who first reported that vertigo was caused by inner ear disorders in an article published in 1861.
Meniere's disease is caused by a dysfunction of the endolymphatic sac (semi-circular canals) in the inner ear - also known as the labyrinth. The labyrinth is a system of small fluid-filled channels that send signals of sound and balance to the brain. It is an unpredictable disease that requires various types of treatment.
Symptoms of Meniere's disease
Symptoms vary from person-to-person. Symptoms can occur suddenly, and their frequency and duration differ.
A symptom is something the patient feels or detects, such as dizziness, while a sign is something other people, including a doctor, may notice, such as a rash.
The primary symptom of Meniere's disease is vertigo
The principle symptoms include:
- Vertigo - usually the most striking Meniere's disease symptom, which includes:
- A feeling that you are spinning, even when you are stationary
- Irregular heartbeats (palpitations)
- Tinnitus - you sense noise or ringing, buzzing, roaring, whistling or hissing in your ear, which is generated from inside your body. You will be more aware of it either during quiet times or when you are tired.
- Hearing loss - hearing loss may fluctuate, especially early on in the course of the disease. The patient may also be especially sensitive to loud sounds. Eventually, most people experience some degree of long-term hearing loss.
The three stages of Meniere's disease
- Early stage - sudden and unpredictable episodes of vertigo. Often the patient will experience nausea, dizziness and vomiting during the episodes. An episode may last from about 20 minutes to a full 24 hours. During episodes there will be some hearing loss, which returns to normal after it is over. The ear may feel uncomfortable and blocked, with a sense of fullness or pressure (aural fullness). Tinnitus is also common.
- Middle stage - vertigo episodes continue, but are usually less severe. Tinnitus and hearing loss, on the other hand, get worse. Some patients during this stage may experience periods of complete remission - symptoms just go away and seem to have gone forever. These periods of remission can last several months.
- Late stage - vertigo episodes become even less frequent, and in some cases never come back. Balance problems, though, continue. Patients will feel especially unsteady when it is dark and they have less visual input to help maintain balance. Hearing and tinnitus typically get progressively worse.
The following symptoms are also possible (known as secondary symptoms):
Anxiety, stress, depression - because of Meniere's disease's unpredictability many patients become, anxious, depressed and stressed. The disease can have a detrimental impact on the sufferer's work, especially if they have to climb ladders or operate machinery. As hearing gets progressively worse the patient may find it more difficult to interact with other people.
Some people cannot drive, further limiting their independence, job prospects, freedom and access to social contacts. It is important for patients who experience stress, anxiety and/or depression to tell their doctor.
Causes of Meniere's disease
Experts believe the disease is caused by an abnormality in the composition and/or amount of fluid in the inner ear. However, they do not know what factors cause these inner-ear changes.
In the inner ear, there is a cluster of connected passages and cavities - a labyrinth. The outer part of the inner ear is where the bony labyrinth is. Inside there is a soft structure of membrane (membranous labyrinth), which is a smaller version of the bony labyrinth with a similar shape.
The membranous labyrinth contains endolymph - a fluid. The membranous labyrinth has hair-like sensors that respond to the fluid's movement. The sensors create nerve impulses that travel to the brain.
Different parts of the inner ear are actively involved in various types of sensory perception:
- Our ability to detect our own acceleration movement in any direction comes from sensors in a portion of the membrane in the vestibule (the center section of the labyrinth).
- Three loops (semicircular canals) branch off from one side of the vestibule. The sensors in the semicircular canals help us maintain balance; they sense our own rotational motion
- On the other side of the vestibule is the cochlea (a structure shaped like a snail) - this is the hearing part of the inner ear. Bones in the middle ear vibrate and create waves in the inner ear fluid - the sensors in the cochlea interpret these waves and translate them into impulses which are sent to the brain.
For all of the sensors in the inner ear to work properly, the fluid has to be at the right pressure, volume and chemical composition. Certain factors present in Meniere's disease alter the properties of the inner ear fluid, which cause the disease's symptoms.
Meniere's disease very rarely affects both ears.
On the next page, we look at the diagnosis, treatment and complications of Meniere's disease