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Meniere's Disease

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What is Meniere's Disease?

  • Ménière disease is a syndrome in which you experience episodes of
  • Between the unpredictable attacks, you usually do not have any problems or symptoms of the disease.
  • Ménière disease was first described in 1861 by the French physician Prosper Ménière. Yet the cause of this syndrome still remains largely unknown.
  • The diagnosis of the disease is usually based on a careful history and physical examination by a doctor, but other tests may be needed for a definitive diagnosis and to plan treatment options.
  • Ménière disease affects people of all ages, especially those of middle age or older. It is, however, uncommon in children.

What Causes Meniere's Disease?

The most common causes of the disease are still unknown. It is suspected that food allergy may play a part. Some suspect that Ménière disease is the response of the inner ear to injury. In any case, if someone in your family has it, you are at higher risk for developing it.

What Are the Symptoms of Meniere's Disease?

Warning symptoms such as fullness or pressure in one ear may come before an acute episode of the disease, or attacks may occur spontaneously.

  • Common symptoms are these:
    • Fluctuating hearing loss with distortion of sounds (especially lower tones) and difficulty with speech discrimination
    • Ringing in the affected ear (tinnitus)
    • A sense of the room spinning (vertigo)
    • A cold sweat, nausea, and vomiting, or generalized weakness during the attack
  • The episodes are unpredictable and usually last from 1 hour to a few hours, depending on the severity of the disease.
  • Recurrence of the attacks is a cardinal feature of Ménière disease. Typically the attacks are few, but the usual pattern of Ménière disease is increasing frequency and severity of the symptoms. The disease can be very disabling as the frequency and severity of the attacks increases.
  • Early in the disease, the symptoms usually go away in several hours, but hearing loss may take a day or more to return to normal. Hearing loss can become permanent and, due to changes in the middle ear, may lead to intolerance of any loud noises.

When Should I Call the Doctor about Meniere's Disease?

Call your doctor and discuss your symptoms if any of the following occur.

  • Your attack lasts for more than 3 hours.
  • The symptoms during the attack become more severe.
  • You pass out.
  • You suffer hearing loss for more than 24 hours.
  • The attack is different than your typical (previous) episodes or does not respond to home treatments including prescribed medications.

If your doctor is not available, or if the doctor recommends treatment and workup, you should go to the hospital's emergency department for further evaluation to rule out other potential causes of the symptoms or to try other treatment options.

What Are the Exams and Tests to Diagnose Meniere's Disease?

The diagnosis of Ménière disease is made based on a careful history and physical exam. If the workup findings are normal and the classic symptoms continue, the diagnosis of Ménière disease is made. A diagnosis of classic or suspected Ménière disease may be made.

  • Other potentially treatable disease processes and causes for the symptoms, however, must be ruled out.
  • Typically, your doctor will perform a series of basic lab tests, a hearing test, and may consider an imaging study such as an MRI (brain scan) to rule out other causes for the symptoms.

Are there Home Remedies for Meniere's Disease?

The best way to manage an attack at home is to minimize the symptoms.

  • Lie in a quiet room with your eyes closed.
  • Try medications prescribed by your doctor: Medications that help decrease anxiety such as diazepam (Valium) or prochlorperazine (Compazine) can be used to help shorten and decrease the severity of the symptoms. Your doctor can prescribe these types of medications and others after a complete evaluation and treatment plan is made. If the vertigo is severe and accompanied with nausea and vomiting, suppository medications may be necessary.
  • If these treatments do not help during an attack, seek further medical evaluation for other treatment options. Rule out any other potential diseases.

What Is the Treatment for Meniere's Disease?

The decision to manage Ménière's disease medically or surgically should be made with your doctor in order to get the best results from treatment options available.

  • Most acute attacks are managed conservatively at home, or with medications prescribed by your doctor such as diazepam (Valium), which decreases anxiety, and meclizine (Antivert), which decreases the spinning sensation. Other medications are available but typically require evaluation by an ear, nose, and throat specialist for use.
  • Long-term management of Ménière disease is aimed at reducing the frequency and severity of the spells. A diet low in salt may help. So medications that decrease the sodium load (diuretics) may be prescribed by your doctor.

What Is the Surgery for Meniere Disease?

Most people respond to medical management, but a few may need surgical treatment by a specialist to correct potential problems in the inner ear.

How Can I Prevent Meniere's Disease?

No measures will prevent Ménière disease, but you can take preventive measures to avoid or minimize attacks and consequences of attacks.

  • Reduce salt in your diet.
  • Stop smoking.
  • Avoid Alcohol and Caffeine
  • Avoid exposure to loud noises.
  • Manage stress.
  • Use caution at home and on the job to avoid falling or having an accident if you feel dizzy.

What Is the Prognosis for Meniere's Disease?

Most people can manage their symptoms with diet and lifestyle modifications and a medical plan prescribed by their doctor.

  • With a thorough evaluation and if you are motivated, you can often control attacks. Careful follow-ups with your primary care doctor and any consultants are needed on a regular basis to monitor symptoms, progress, and adjust therapy throughout the disease process.
  • Only a minority of people require a surgical procedure to control their attacks. Thorough evaluation by an ear, nose, and throat specialist should be considered if medical management fails.
  • If hearing levels decrease over time, amplification of sound or surgical management in extreme cases may be needed to improve hearing.

Support Groups and Counseling for Meniere's Disease?

The psychological aspect of the disease can be devastating as well. Many people live in constant fear of violent attacks of disabling vertigo. Some require counseling, and a few may require psychiatric evaluation and medications to cope with their disease.

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Reviewed on 11/21/2017
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