Ménière Disease

What is Ménière disease?

Ménière disease is a balance disorder. It’s caused by an abnormality in part of the inner ear called the labyrinth. Fluid buildup here can cause a severe spinning feeling (vertigo) and affect the hearing.

What causes Ménière disease?

The labyrinth holds the organs of balance and hearing. It’s made up of 2 parts:

• Bony labyrinth

• Membranous labyrinth

The membranous labyrinth is encased in bone and contains a fluid called endolymph.

When the head moves, the endolymph also moves. This causes nerve receptors in the membranous labyrinth to signal the brain about the body's motion.

Too much endolymph buildup in the labyrinth can interfere with the normal balance and hearing signals between the inner ear and the brain. This is Ménière disease.

Fluid buildup in this area may be caused by:

• Allergies

• Abnormal immune system response

• Abnormal fluid drainage caused by a blockage

• Head injury

• Genetics

• Migraine headaches

• Viral infection

Most often, Ménière disease is caused by more than one factor.

Who is at risk for Ménière disease?

Anyone can get Ménière disease. It’s more common in people in their 40s and 50s. There is no cure.

What are the symptoms of Ménière disease?

Symptoms can happen suddenly and may happen daily. Or they may not happen often. The symptoms are most often in one ear. But they can affect both ears. These are the most common symptoms of Ménière disease:

• Vertigo, a severe spinning feeling that can cause:

  • Severe nausea

  • Vomiting

  • Sweating

• Ringing in the ears (tinnitus)

• Loss of hearing or muffled hearing

• Not able to hear low frequencies

• Pressure in the affected ear

• Loss of balance

• Headaches

The symptoms of Ménière disease may look like other health problems. Always check with your healthcare provider for a diagnosis.

How is Ménière disease diagnosed?

The healthcare provider will review your health history and give you a physical exam. You may also need some tests, such as:

• Hearing test. This will help find any changes in hearing related to disease in the middle ear or other causes.

• Balance test. This may include an electronystagmogram (ENG), rotational testing, or balance platform testing.

• MRI. This is done to see if a tumor is present.

• Electrocochleography (ECOG). This test measures electrical activity of the inner ear.

You may see specialists including:

• Audiologist

• An ear, nose, and throat specialist (ENT or otolaryngologist)

• Neurologist

How is Ménière disease treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

There is no cure for Ménière disease. Treatment may include:

• Surgery. Several types of surgery are effective for treating balance problems from Ménière disease.

• Medicine. Medicines may be given to control allergies, reduce fluid buildup, reduce dizziness, or improve the blood circulation in the inner ear.

• Change in diet. Removing caffeine, chocolate, alcohol, and salt may reduce the frequency and intensity of symptoms.

• Behavior therapies. Reducing stress may lessen the severity of the disease symptoms.

• Hearing aids. These can help treat hearing impairments caused by the disease.

What are possible complications of Ménière disease?

Vertigo is one of the main symptoms of Ménière disease. It can cause falls or trouble driving, or prevent other normal activities of daily living. Lasting (permanent) hearing loss may also happen. These problems can cause depression and anxiety. It may be hard to work or interact with your family and friends.

Living with Ménière disease

It can be hard to live with Ménière disease because the condition is very unpredictable. Symptoms may occur suddenly with no warning. To manage the disease and cope with sudden attacks, it's helpful to talk with your healthcare provider. Find out ahead of time how to handle symptoms when they occur, what medicines to take, and know when you should get medical care.

Key points about Ménière disease

• Ménière disease is a disorder caused by fluid buildup in the chambers in the inner ear.

• It may be caused by several things, including allergies, abnormal immune system response, head injury, migraine headaches, or a viral infection.

• Symptoms include a severe spinning feeling (vertigo), nausea, vomiting, loss of hearing, ringing in the ears, headache, loss of balance, and sweating.

• Anyone can get Ménière disease. But it’s more common in people in their 40s and 50s.

• There is no cure. Treatment can help manage symptoms and may include diet changes, behavior therapy, hearing aids, medicine, and surgery.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new directions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions, especially after office hours and on weekends and holidays.