What is Meniere’s Disease?

Meniere's disease is a disorder of the inner ear. The underlying cause is unknown, but it is thought that a build-up of fluid in the labyrinth from time to time causes the symptoms.

Many factors are probably involved in the development of the disease. It has often been put down to viral infections of the inner ear, head injury, a hereditary predisposition (15% of patients have a family history of MD), and allergy. Migraine may cause symptoms that overlap with Meniere's disease and hearing tests are therefore required to confirm a diagnosis.

What are the symptoms of Menieres?

Episodes of vertigo/nausea/vomiting/unsteadiness
Tinnitus - ringing in the ears, and fullness or pressure in the ear
Fluctuating hearing loss during attacks, with a progressive hearing loss in the affected ear over time.

Meniers Attacks:

Can last between 2-4 hours
Following a severe attack, most people find that they are exhausted and must sleep for several hours.
Meniere's episodes may occur in clusters - that is, several attacks may occur within a short period of time. However, years may pass between episodes

How is a diagnosis made?

The diagnosis is usually based on the patient’s history of typical symptoms. A hearing test repeated over time helps confirm the diagnosis. The diagnosis may also only become clear over time as the typical pattern of recurring attacks develops.

Simple clinic balance tests will be carried out by either an ENT Consultant or Specialist Physiotherapist.

Occasionally scans and other specific tests may be required, but these are not done in all patients.

Did you know?

About 1 in 2000 people develops MD.
It can occur at all ages, and most frequently starts between ages of 20 and 50 years.
Initially the disease usually affects one ear, but 15% of people will have both ears affected.
Although an acute attack can be incapacitating, the disease itself is not fatal.
Menieres is an over-diagnosed condition, you need all 3 of the above symptoms to be correctly diagnosed.

Treatment options:

You will receive advice on any medication that may help.
Recent evidence suggests that people with Meniere’s disease can benefit from steroid (powerful anti-inflammatory medication) injections placed in the ear in small doses. Trials have shown that they reduce the frequency and severity of vertigo attacks.
Audiologists will assess and help with hearing loss and tinnitus, providing hearing aids as needed, white noise generators to help with tinnitus, and tinnitus counselling where necessary.
Specialised physiotherapy (vestibular rehabilitation) may be needed if there is a balance problem in between attacks. – the Physiotherapist will be able to advise on interventions/exercises to help restore the balance between the attacks. Unfortunately, they will not be able to help reduce the attacks themselves
Diet and life style changes may be recommended.
Some patients may need counselling to help with the anxiety associated with MD
Surgical treatment is only indicated in extreme circumstances

Top Tips:

Most people with MD cope well with their symptoms once they have a clear diagnosis and advice on self- management.
During an acute attack, lay down on a firm surface. Most people prefer to lie down until the severe vertigo (spinning) passes, and then get up SLOWLY. After the attack subsides, you'll probably feel very tired and need to sleep for several hours.
If you have been given medication to reduce vomiting and nausea take it immediately.
A low-sodium diet may help to reduce the frequency of attacks.
Regular exercise is beneficial
Methods to combat stress may help ease the anxiety associated with the episodes.
Stopping smoking if you are a smoker./li>
Follow any further advice given by your health care professional

Useful web pages:

https://www.nhs.uk/conditions/menieres-disease/

http://www.menieres.org.uk/information-and-support/symptoms-and-conditions/menieres-disease

https://patient.info/health/tinnitus-leaflet/menieres-disease