What Are Symptoms of Ménière’s Disease?
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Ménière’s disease (also called idiopathic endolymphatic hydrops) is an inner ear disorder that causes problems with hearing and balance. Ménière’s disease usually affects only one ear. It can develop at any age, but it most commonly occurs in adults between the ages of 40 and 60 years.
What Are Symptoms of Ménière’s Disease?
Symptoms of Ménière’s disease usually only affect one ear and include:
- Severe dizziness
- Spinning sensation (vertigo)
- Episodes may come on suddenly and last several minutes to a few hours
- Severe vertigo in which patients lose their balance and fall (“drop attacks”)
- Nausea
- Vomiting
- Ringing in the ears (tinnitus)
- Hearing loss
- May become permanent over time
- Feeling of fullness, congestion, or pressure in the ear
What Causes Ménière’s Disease?
The symptoms of Ménière’s disease are caused by the buildup of fluid in the part of the inner ear called the labyrinth, which contains the organs of balance.
The exact cause of Ménière’s disease is unknown but it may be due to
- Constrictions in blood vessels similar to those that cause migraine headaches
- A consequence of viral infections or allergies
- An autoimmune reaction
- Genetics (Ménière’s disease appears to run in families)
Triggers for Ménière’s disease attacks (“drop attacks”) include
- Allergies
- Atmospheric changes
- Bright lights
- Chemical exposure/smells
- Dietary triggers
- Artificial sweetener
- Salt
- MSG
- Alcohol
- Exertion
- Certain movements
- Bending at the waist
- Tilting the head back
- Sudden head movements
- Over-the-counter (OTC) medications
- Aspirin
- Ibuprofen
- Antacids
- Smoking cessation products
- Smoking
- Stress
- Travel
How Is Ménière’s Disease Diagnosed?
There is no definitive test used to diagnose Ménière’s disease. Diagnosis may be based upon a patient’s medical history and the presence of the following symptoms:
- Two or more episodes of vertigo lasting at least 20 minutes each
- Ringing in the ears (tinnitus)
- Temporary hearing loss
- A feeling of fullness in the ear
Tests that may be ordered to confirm a diagnosis of Ménière’s disease or to rule out other conditions include:
- Magnetic resonance imaging (MRI) scan of the brain
- Computed tomography (CT) scan of the brain
- Balance testing
- Hearing test (audiometry)
- Blood tests to check for infection or hormone problems, such as diabetes
Ménière’s disease is usually treated by an otolaryngologist (an ear, nose, and throat doctor, or ENT).
What Is the Treatment for Ménière’s Disease?
There is no cure for Ménière’s disease. Treatments are aimed at helping patients manage the condition.
- Medications to relieve dizziness and shorten attacks include
- Meclizine
- Diazepam
- Glycopyrrolate
- Lorazepam can help relieve dizziness and shorten the attack.
- Cognitive therapy to help patients cope with the unexpected nature of attacks and to reduce anxiety about future attacks
- Injections into the middle ear
- The antibiotic gentamicin helps control vertigo but significantly raises the risk of hearing loss because gentamicin can damage the microscopic hair cells in the inner ear that aid in hearing
- Corticosteroids can help reduce dizziness without the risk of hearing loss
- Pressure pulse treatment
- A device that fits into the outer ear and delivers intermittent air pressure pulses to the middle ear which helps prevent dizziness
- Hearing aids for hearing loss
- Physical therapy exercises to help with balance
- Dietary and lifestyle modifications
- Salt restriction and diuretics (water pills) can help control dizziness by reducing the amount of fluid the body retains
- Limiting or avoiding trigger foods (foods not to eat when you have Ménière’s disease)
- Caffeine
- Chocolate
- Alcohol
- Foods with high cholesterol or triglyceride content
- High carbohydrate foods
- Excessive sweets and candy
- Patients should not smoke and should avoid nicotine
- Surgery
- A last resort when all other treatments fail to relieve dizziness
- Some surgical procedures are performed on the endolymphatic sac to decompress it
- Other surgery involves cutting the vestibular nerve
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