How does Meniere's disease affect the body? - Meniere's Disease - Sharecare Meniere's Disease How does Meniere's disease affect the body? A Honor Society of Nursing (STTI) answered In the worst cases, Meniere's disease can be incapacitating. Vertigo and dizziness may be so bad that patients fall down while trying to walk. Patients may lose their hearing in the affected ear or ears. Short-term effects may include nausea and vomiting. Patients may become anxious or depressed. Helpful? This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs. Videos (6) Meniere's Disease Meniere's disease is a disorder of the inner ear that causes severe spells of vertigo, making you feel like you're spinning. You can also have hearing loss, ringing (tinnitus, pronounced either TINN-itus or tinn-UH-tus)) or a feeling of fullness in your ear. (It usually affects just one ear).

Doctors don't fully understand Meniere's Disease but suspect that its caused by a combination of how fluid drains (or does not drain) from your ear, allergies, viruses and genes. There is no known cure for Meniere's Disease, but vertigo is treatable. Meniere's Disease Q&As Meniere's Disease - National Library of Medicine - PubMed Health Surgery for Ménière's disease Ménière's disease is characterised by recurrent attacks of three major symptoms: vertigo (rotational dizziness), deafness and tinnitus (ringing of the ears), and/or aural fullness, all of which are discontinuous and variable in intensity. The symptoms of Ménière's disease are thought to be caused by excess pressure in the fluids of the inner ear which leads to sudden attacks of vertigo and hearing loss. A number of surgical procedures, of varying levels of invasiveness, have been developed to reduce the symptoms of Ménière's disease, but it is not clear whether or not these are effective. The surgical interventions can be categorised as two types: one type of surgical intervention aims to affect the natural history of the disease, with conservation of vestibular function.

The other type aims to relieve symptoms by abolishing vestibular function. Both types of surgical intervention are considered in this review. Despite an extensive search the review authors only found two randomised controlled trials studying surgical interventions for Ménière's disease. Both of these trials, involving a total of 59 patients, studied endolymphatic sac surgery; one comparing it to placebo surgery and the other to a different type of surgery. Neither trial detected a significant difference between the treatment and control group. Diuretics for the treatment of Ménière's disease or syndrome Diuretics (drugs which reduce fluid accumulation in the body) are commonly used in the management of the symptoms of vertigo, hearing loss, tinnitus or aural fullness in patients with Ménière's disease. 'Endolymphatic hydrops' is an increase in the pressure of the fluids in the chambers of the inner ear and is thought to be the underlying cause of Ménière's disease. Diuretics are believed to work by reducing the volume (and therefore also the pressure) of these fluids. The authors of this systematic review carried out an extensive search but could not identify any randomised controlled trials of sufficient quality to include in the review.

There is no good evidence about the effect of diuretics on the symptoms of Ménière's disease and further research is needed. Betahistine for Ménière's disease or syndrome Ménière's disease is a disorder of the inner ear which results in a spinning form of dizziness (vertigo), hearing loss and ringing in the ear (tinnitus), and can be disabling. It has no known cause. When it is secondary to a known inner ear disorder, it is called Ménière's syndrome. Both can be difficult to diagnose. The drug betahistine hydrochloride (Serc®, Betaserc®) has been used to reduce the frequency and severity of the attacks. While the drug is very acceptable to those who use it, the review of trials did not find enough evidence to show whether it is helpful. Further research is needed. Surgery for Ménière's disease Ménière's disease is characterised by recurrent attacks of three major symptoms: vertigo (rotational dizziness), deafness and tinnitus (ringing of the ears), and/or aural fullness, all of which are discontinuous and variable in intensity.

The symptoms of Ménière's disease are thought to be caused by excess pressure in the fluids of the inner ear which leads to sudden attacks of vertigo and hearing loss. A number of surgical procedures, of varying levels of invasiveness, have been developed to reduce the symptoms of Ménière's disease, but it is not clear whether or not these are effective. The surgical interventions can be categorised as two types: one type of surgical intervention aims to affect the natural history of the disease, with conservation of vestibular function. The other type aims to relieve symptoms by abolishing vestibular function. Both types of surgical intervention are considered in this review. Despite an extensive search the review authors only found two randomised controlled trials studying surgical interventions for Ménière's disease. Both of these trials, involving a total of 59 patients, studied endolymphatic sac surgery; one comparing it to placebo surgery and the other to a different type of surgery. Neither trial detected a significant difference between the treatment and control group.

Diuretics for the treatment of Ménière's disease or syndrome Diuretics (drugs which reduce fluid accumulation in the body) are commonly used in the management of the symptoms of vertigo, hearing loss, tinnitus or aural fullness in patients with Ménière's disease. 'Endolymphatic hydrops' is an increase in the pressure of the fluids in the chambers of the inner ear and is thought to be the underlying cause of Ménière's disease. Diuretics are believed to work by reducing the volume (and therefore also the pressure) of these fluids. The authors of this systematic review carried out an extensive search but could not identify any randomised controlled trials of sufficient quality to include in the review. There is no good evidence about the effect of diuretics on the symptoms of Ménière's disease and further research is needed. Betahistine for Ménière's disease or syndrome Ménière's disease is a disorder of the inner ear which results in a spinning form of dizziness (vertigo), hearing loss and ringing in the ear (tinnitus), and can be disabling. It has no known cause. When it is secondary to a known inner ear disorder, it is called Ménière's syndrome.

Both can be difficult to diagnose. The drug betahistine hydrochloride (Serc®, Betaserc®) has been used to reduce the frequency and severity of the attacks. While the drug is very acceptable to those who use it, the review of trials did not find enough evidence to show whether it is helpful. Further research is needed. Ménière's Disease | NIDCD Ménière's Disease Where can I find additional information about Ménière’ disease? What is Ménière’s disease? Ménière’s disease is a disorder of the inner ear that causes severe dizziness (vertigo), ringing in the ears (tinnitus), hearing loss, and a feeling of fullness or congestion in the ear. Ménière’s disease usually affects only one ear. Attacks of dizziness may come on suddenly or after a short period of tinnitus or muffled hearing. Some people will have single attacks of dizziness separated by long periods of time. Others may experience many attacks closer together over a number of days. Some people with Ménière’s disease have vertigo so extreme that they lose their balance and fall.

These episodes are called “drop attacks.” Ménière’s disease can develop at any age, but it is more likely to happen to adults between 40 and 60 years of age. The National Institute on Deafness and Other Communication Disorders (NIDCD) estimates that approximately 615,000 individuals in the United States are currently diagnosed with Ménière’s disease and that 45,500 cases are newly diagnosed each year. What causes the symptoms of Ménière’s disease? The labyrinth in relation to the ear The labyrinth is composed of the semicircular canals, the otolithic organs (i.e., utricle and saccule), and the cochlea. Inside their walls (bony labyrinth) are thin, pliable tubes and sacs (membranous labyrinth) filled with endolymph. Credit: NIH/NIDCD The symptoms of Ménière’s disease are caused by the buildup of fluid in the compartments of the inner ear, called the labyrinth. The labyrinth contains the organs of balance (the semicircular canals and otolithic organs) and of hearing (the cochlea). It has two sections: the bony labyrinth and the membranous labyrinth.

The membranous labyrinth is filled with a fluid called endolymph that, in the balance organs, stimulates receptors as the body moves. The receptors then send signals to the brain about the body’s position and movement. In the cochlea, fluid is compressed in response to sound vibrations, which stimulates sensory cells that send signals to the brain. In Ménière’s disease, the endolymph buildup in the labyrinth interferes with the normal balance and hearing signals between the inner ear and the brain. This abnormality causes vertigo and other symptoms of Ménière’s disease. Why do people get Ménière’s disease? Many theories exist about what happens to cause Ménière’s disease, but no definite answers are available. Some researchers think that Ménière’s disease is the result of constrictions in blood vessels similar to those that cause migraine headaches. Others think Ménière’s disease could be a consequence of viral infections, allergies, or autoimmune reactions. Because Ménière’s disease appears to run in families, it could also be the result of genetic variations that cause abnormalities in the volume or regulation of endolymph fluid. How does a doctor diagnose Ménière’s disease?

Ménière’s disease is most often diagnosed and treated by an otolaryngologist (commonly called an ear, nose, and throat doctor, or ENT). However, there is no definitive test or single symptom that a doctor can use to make the diagnosis. Diagnosis is based upon your medical history and the presence of: Two or more episodes of vertigo lasting at least 20 minutes each Tinnitus Temporary hearing loss A feeling of fullness in the ear Some doctors will perform a hearing test to establish the extent of hearing loss caused by Ménière’s disease. To rule out other diseases, a doctor also might request magnetic resonance imaging (MRI) or computed tomography (CT) scans of the brain. How is Ménière’s disease treated? Ménière’s disease does not have a cure yet, but your doctor might recommend some of the treatments below to help you cope with the condition. Medications. The most disabling symptom of an attack of Ménière’s disease is dizziness. Prescription drugs such as meclizine, diazepam, glycopyrrolate, and lorazepam can help relieve dizziness and shorten the attack. Salt restriction and diuretics.

Limiting dietary salt and taking diuretics (water pills) help some people control dizziness by reducing the amount of fluid the body retains, which may help lower fluid volume and pressure in the inner ear. Other dietary and behavioral changes. Some people claim that caffeine, chocolate, and alcohol make their symptoms worse and either avoid or limit them in their diet. Not smoking also may help lessen the symptoms. Cognitive therapy. Cognitive therapy is a type of talk therapy that helps people focus on how they interpret and react to life experiences. Some people find that cognitive therapy helps them cope better with the unexpected nature of attacks and reduces their anxiety about future attacks. Injections. Injecting the antibiotic gentamicin into the middle ear helps control vertigo but significantly raises the risk of hearing loss because gentamicin can damage the microscopic hair cells in the inner ear that help us hear. Some doctors inject a corticosteroid instead, which often helps reduce dizziness and has no risk of hearing loss. Pressure pulse treatment. The U.S. Food and Drug Administration (FDA) recently approved a device for Ménière’s disease that fits into the outer ear and delivers intermittent air pressure pulses to the middle ear.

The air pressure pulses appear to act on endolymph fluid to prevent dizziness. Location of endolymphatic sac Credit: NIH/NIDCD Surgery. Surgery may be recommended when all other treatments have failed to relieve dizziness. Some surgical procedures are performed on the endolymphatic sac to decompress it. Another possible surgery is to cut the vestibular nerve, although this occurs less frequently. Alternative medicine. Although scientists have studied the use of some alternative medical therapies in Ménière’s disease treatment, there is still no evidence to show the effectiveness of such therapies as acupuncture or acupressure, tai chi, or herbal supplements such as gingko biloba, niacin, or ginger root. Be sure to tell your doctor if you are using alternative therapies, since they sometimes can impact the effectiveness or safety of conventional medicines. What is the outlook for someone with Ménière’s disease? Scientists estimate that six out of 10 people either get better on their own or can control their vertigo with diet, drugs, or devices. However, a small group of people with Ménière’s disease will get relief only by undergoing surgery. What research about Ménière’s disease is being done?

Insights into the biological mechanisms in the inner ear that cause Ménière’s disease will guide scientists as they develop preventive strategies and more effective treatment. The NIDCD is supporting scientific research across the country that is: Determining the most effective dose of gentamicin with the least amount of risk for hearing loss. Developing an in-ear device that uses a programmable microfluid pump (the size of a computer chip) to precisely deliver vertigo-relieving drugs to the inner ear. Studying the relationship between endolymph volume and inner ear function to determine how much endolymph is “too much.” Researchers are hoping to develop methods for manipulating inner ear fluids and treatments that could lower endolymph volume and reduce or eliminate dizziness. Where can I find additional information about Ménière’ disease? NIDCD maintains a directory of organizations that can answer questions and provide printed or electronic information on Ménière’s. Please see the list of organizations at .

Use the following keywords to help you search for organizations that can answer questions and provide printed or electronic information on Ménière’s disease: Meniere's Disease - Symptoms, Diagnosis, Treatment of Meniere's Disease - NY Times Health Information Ringing or roaring in the affected ear, called tinnitus Vertigo, or dizziness Severe vertigo is the symptom that causes the most problems. With vertigo, you feel as though you are spinning or moving, or that the world is spinning around you. Nausea, vomiting, and sweating often occur. Symptoms get worse with sudden movement. Often, you will need to lie down. You may feel dizzy and off-balance for anywhere from 20 minutes to 24 hours. Usually hearing loss is only in one ear, but it may affect both ears. Hearing tends to improve between attacks but gets worse over time. Low frequency hearing is lost first. You also may have roaring or ringing in the ear (tinnitus), along with a sense of pressure in your ear Other symptoms include: Back to Top Treatment There is no known cure for Meniere's disease. However, lifestyle changes and some treatments can help relieve symptoms. Your doctor may suggest ways to reduce the amount of fluid in your body.

This can often help control symptoms. Water pills (diuretics) may help relieve fluid pressure in the inner ear A low-salt diet may also help To help ease symptoms and stay safe: Avoid sudden movements, which may worsen symptoms. You may need help walking during attacks. Avoid bright lights, TV, and reading during attacks. They can make symptoms worse. Do not drive, operate heavy machinery, or climb until 1 week after your symptoms disappear. A sudden dizzy spell during these activities can be dangerous. Remain still and rest when you have symptoms. Gradually increase your activity after attacks. Symptoms of Meniere's disease can cause stress. Make healthy lifestyle choices to help you cope: Eat a well-balanced, healthy diet. Don't overeat. Exercise regularly, if possible. Your health care provider may prescribe: Antinausea medicines to relieve nausea and vomiting Diazepam (Valium) or motion sickness medicines, such as meclizine (Antivert, Bonine, Dramamine) to relieve dizziness and vertigo You may need ear surgery if your symptoms are severe and do not respond to other treatments. Surgery to cut the vestibular nerve helps control vertigo. It does not damage hearing.

Injecting steroids or an antibiotic called gentamicin directly into the middle ear can help control vertigo. Removing part of the inner ear (labyrinthectomy) helps treat vertigo. This causes complete hearing loss. Hearing aids may be needed for severe hearing loss. Back to Top References Crane BT, Schessel DA, Nedzelski J, Minor LB. Peripheral vestibular disorders. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery . 5th ed. Philadelphia, Pa: Mosby Elsevier;2010:chap 165. Phillips JS, Westerberg B. Intratympanic steroids for Ménière's disease or syndrome. Cochrane Database Syst Rev. 2011 Jul 6;(7):CD008514. Post RE, Dickerson LM. Dizziness: a diagnostic approach. Am Fam Physician . 2010;82:361-369. Pullens B, van Benthem PP. Intratympanic gentamicin for Ménière's disease or syndrome. Cochrane Database Syst Rev.

2011 Mar 16;(3):CD008234. More Information on This Topic News & Features Review Date: 9/25/2013 Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team. A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission ( URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation ( A.D.A.M. Copyright The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited. Meniere's Disease | The Oregon Clinic The Oregon Clinic Specialty Medicine with Commitment, Care & Compassion Search form Overview Meniere’s Disease Meniere's disease is a condition that affects the fluids in the inner ear. It causes symptoms like ringing in the ears (tinnitus) and dizziness (vertigo). Another symptom is hearing loss that comes and goes. Sometimes there is a feeling of fullness or pressure in the ear. The inner ear fluids normally stay at a constant pressure. In Meniere's disease, the pressure may change. The change is due to a change in the body's overall fluid balance. When the pressure changes, you may have dizziness, ringing, pressure or hearing loss. Treatments Meniere's disease treatment Salt is a major factor in changing the fluid balance in the body.

Salt (sodium) is in the fluids that are part of all body tissues. Large doses of sodium cause a change in those fluids. That change causes a change in the inner car fluids. This can lead to an episode of hearing loss, tinnitus or the other symptoms mentioned. Perhaps you've noticed this after eating pizza or salty popcorn. Both of these foods are high in sodium. One of the ways we treat Meniere's disease is to put you on a low salt diet. Daily Sodium Allowance We suggest 1.5 grams (or 1500 milligrams) each day for people with Meniere’s disease. This is equivalent to 500 mg per meal (1/2 teaspoon) or 1 ½ teaspoons per day. Most people can reach this level if they follow the rules below. 4 Ways to Shake the Salt Habit 1. Take the saltshaker off the table. (Try replacing the salt in the shaker with herbs. A dietitian can suggest herb mixtures that you might like.) 2. Reduce the amount of salt you use in cooking and baking. Do this a little at a time. Most recipes still taste fine with much less salt. Try using spices and herb seasonings instead of salt.

3. Limit your use of processed "convenience" foods. This is most food that comes in packages or cans. Most food that is "ready to eat' or just needs heating is high in sodium. When you do buy a packaged/canned food, buy a brand that doesn't list salt or sodium as one of the first three or four ingredients. 4. Beware of fast foods. They are almost all high in sodium. Fats in the Diet Doctors and dietitians also suggest a diet low in total fat. This is because people with Meniere's disease may also have high levels of fat in their blood. When the amount of fat in the blood is lowered, the symptoms of Meniere's disease often improve. The first step is to reduce the total amount of fat you eat. 1. Cutting out "visible" fats is the easiest approach. This means things like: Using a little jelly instead of butter on toast Putting low fat yogurt instead of sour cream on potatoes Taking the skin off chicken before cooking it Cutting the amount of fat and oil in recipes in half Using a non-stick fry pan. 2. Read labels to know how much and what kind of fat a food contains.

Try to avoid foods made with lard or palm, palm kernel or coconut oils. These are saturated fats, and are more likely to cause problems. Instead choose low fat foods and foods made with vegetable oils. 3. Switch to a low fat or skim milk. 4. Eat less red meat and more fish and skinless poultry. If you can make these changes, you may also lower your cholesterol levels. This may reduce your risk of heart disease. In addition to a low salt, low fat diet, there are some other diet changes that can help reduce symptoms of Meniere's disease. 1. Spread your eating over the whole day. This spreads out your intake of salt and sugar. It helps to keep body fluids stable. Meal skipping usually means you'll eat large amounts later. 2. Reach and stay at a "healthy" body weight. Your dietitian can help you determine the right weight. 3. Don't get dehydrated (short of fluids). Meniere’s disease is a disorder of body fluids. It's important to drink enough fluids every day to keep the amount of fluid in your body constant. A good rule of thumb is 8 glasses of water a day. Drink more if you exercise or perspire heavily. 4.

Limit (or stop) caffeine and alcohol intake. o Both caffeine and alcohol can worsen Meniere’s disease symptoms. Caffeine can stimulate the inner ear and lead to symptoms. It also acts as a diuretic (causes fluid loss) so it can change your fluid balance. Alcohol is quickly absorbed into the blood stream and inner ear fluids. This can cause problems with balance. Some foods and drinks to avoid are: Alcohol Most teas Coca Cola products 5. Avoid sweets. Sweets have simple sugars that enter the blood quickly after eating. The change in blood sugar can cause a change in fluid balance. For you, that can mean symptoms. Table sugar, honey, brown sugar and corn syrup are all simple sugars. Use them lightly or not at all. 6. If you are sensitive or allergic to any foods, avoid them. A reaction to food often includes a fluid shift. Notice symptoms that happen just after eating certain foods. Some foods that tend to cause problems for some people are: Shellfish Cheese So What's Left to Eat? Does all this sound like there's nothing left to eat? Not so. You will probably have to change your current habits some. However, you can still enjoy many foods, prepared in different ways.

Sample Menu Bowl of cereal (no sugar coating) with banana slices and low-fat milk. Slice of whole-wheat toast, or a muffin with a little jelly Glass of orange juice Cup of decaffeinated coffee or tea Lunch Cup of lentil soup, or cup of low fat yogurt Turkey sandwich on whole grain bread with light mayonnaise, lettuce and tomato Carrot, celery and green pepper sticks Diet pop or herbal tea Dinner Serving of chicken, rice and broccoli casserole Mixed vegetables with sprinkle of lemon juice Herbed dinner roll Tossed salad with low fat dressing Glass of low-fat milk Pretzels with unsalted tops Fresh fruit Bagel with low fat cream cheese or cottage cheese - Non-fat frozen yogurt (once in awhile for a treat as the sugar is high) Meniere's Disease: Symptoms, Diagnosis & Treatments Read This Next Meniere’s disease is a disorder that affects the inner ear. The inner ear is responsible for your balance, as well as hearing. This disorder causes vertigo (a sensation of spinning), hearing problems, and a ringing sound in the ear. Meniere’s disease usually affects only one ear.

The National Institute on Deafness and Other Communication Disorders estimates that 615,000 people in the United States have Meniere’s disease. It’s most likely to occur in people in their 40s and 50s. Meniere’s disease is a chronic (long-term) disease, but treatments and lifestyle changes can help to ease the symptoms. Many people diagnosed with Meniere’s disease will go into remission within a few years after their diagnosis. The cause of Meniere’s disease isn’t known, but scientists believe it’s caused by changes in the fluid in tubes of the inner ear. What Are the Symptoms of Meniere’s Disease? Meniere’s disease symptoms tend to come on as “episodes” or “attacks.” Most people with Meniere’s disease don’t experience symptoms between episodes. Symptoms of Meniere’s disease include: vertigo (attacks can last anywhere from a few minutes to 24 hours) loss of hearing in the affected ear tinnitus (a sensation of ringing) in the affected ear a feeling of fullness in the affected ear loss of balance aural fullness (a feeling that the ear is full or plugged) How Is Meniere’s Disease Diagnosed?

If you’re experiencing symptoms of Meniere’s disease, your doctor will order tests to examine your balance and hearing and to rule out other causes of your symptoms. Hearing Test A hearing test is used to determine if you are experiencing hearing loss. This test is also called audiometry. In this test, you will put on headphones. You will hear noises with a variety of pitches and volumes. You will need to indicate when you can and cannot hear a tone, so the technician can determine if you are experiencing hearing loss. Your hearing will also be tested to determine if you can tell the difference between similar sounds. In this portion of the test, you will hear words through the headphones. You will need to repeat what you hear. The results of this test will tell your doctor if you have a hearing problem in one or both ears. Hearing loss can be either caused by a problem in the inner ear or by a problem with the nerve in the ear. Electrocochleography (ECog) is a test done to measure the electrical activity in the inner ear. An auditory brainstem response (ABR) test checks the function of the hearing nerves and the hearing center in the brain.

These tests can tell your doctor if the problem is caused by your inner ear or with your ear nerve. Balance Tests Balance tests are done to test the function of your inner ear. People who have Meniere’s disease will have a reduced balance response in one of their ears. The balance test most commonly used to test for Meniere’s disease is electronystagmography (ENG). In this test, you will have electrodes placed around your eyes to detect eye movement. This is because the balance response in the inner ear causes eye movements. During this test, both hot and cold water will be pushed into the ear. The water causes the balance function to work. Your involuntary eye movements will be tracked. Any abnormalities can indicate a problem with the inner ear. Rotary chair (also called rotational chair or rotatory chair) testing is less commonly used. It will show your doctor whether your problem is caused by a problem in your ear or your brain. It’s used in addition to ENG testing because the ENG results can be incorrect if there is wax blocking one of your ear’s canals or if your ear is damaged. In this test, the chair is moved while your eye movements are carefully recorded.

Vestibular evoked myogenic potential (VEMP) testing measures the sound sensitivity of the vestibule of the inner ear. Posturography testing helps determine which part of your balance system isn’t functioning properly. Wearing a safety harness and standing bare feet on a platform, you will react to various balance challenges. Other Tests Issues with the brain, such as multiple sclerosis or brain tumor, can cause symptoms similar to Meniere’s disease. Your doctor may order tests to rule out other problems. Your doctor may order a magnetic resonance imaging (MRI) scan or a computerized tomography (CT) scan to assess possible problems with your brain. Medical Treatment for Meniere’s Disease Meniere’s disease is a chronic condition with no cure. However, there are a variety of treatments that can help with your symptoms, ranging from medication to surgery for the most severe cases. Medication Your doctor may prescribe medication to help with the symptoms of Meniere’s disease. Motion sickness medicines can be used to ease symptoms of vertigo, nausea, and vomiting. If nausea and vomiting is a problem for you, your doctor may prescribe an antiemetic (anti-nausea medication).

As Meniere’s disease is thought to be caused by a problem with fluid in the inner ear, your doctor may prescribe a diuretic (a drug that causes increased urine output) to help reduce the amount of fluid. Your doctor can also inject medication into your inner ear by way of your middle ear to help reduce vertigo symptoms. Rehab and Hearing Aids Vestibular rehabilitation exercises can improve symptoms of vertigo. These exercises help to train your brain to account for the difference in balance between your two ears. These exercises can be taught by a physical therapist. Hearing loss can be treated by an audiologist. Usually, this requires being fitted with a hearing aid. Surgery Most people with Meniere’s disease don’t require surgery, but it’s an option for those who have severe attacks and haven’t had success with other treatment options. An endolymphatic sac procedure is done to help decrease the production of fluid and promote fluid drainage in the inner ear. A vestibular nerve section procedure cuts the nerve that connects the ear to the brain, which reduces vertigo while preserving hearing. A labyrithecotomy is done when there is total hearing loss in the ear.

This surgery removes the entire inner ear, which removes the balance and hearing function from that ear. Self-Care and Home Treatment Changing your diet may help to reduce the amount of fluid in the inner ear and ease symptoms. Items to limit or exclude from your diet include: salt alcohol monosodium glutamate (MSG) It’s also important to drink six to eight glasses of water per day, so your body isn’t retaining fluid. Other lifestyle remedies include: resting during vertigo attacks eating regularly (to help regulate fluids in your body) managing anxiety and stress through psychotherapy or medication It’s also important to quit smoking and to avoid any allergens, as both nicotine and allergies can make the symptoms of Meniere’s disease worse. Even though there’s no cure for Meniere’s disease, there are strategies you might want to consider to reduce your symptoms. Talk to your doctor about treatments that can help you cope with Meniere’s disease. Meniere's Disease | American Academy of Otolaryngology-Head and Neck Surgery News media interested in covering the latest from AAO-HNS/F can find information on embargoes, Annual Meeting press registration and more below.

Please direct any interview requests or policy questions to our media and public relations staff at newsroom@entnet.org . What is Ménières disease? Ménières disease describes a set of episodic symptoms including vertigo (attacks of a spinning sensation), hearing loss, tinnitus (a roaring, buzzing, or ringing sound in the ear), and a sensation of fullness in the affected ear. Episodes typically last from 20 minutes up to 4 hours. Hearing loss is often intermittent, occurring mainly at the time of the attacks of vertigo. Loud sounds may seem distorted and cause discomfort. Usually, the hearing loss involves mainly the lower pitches, but over time this often affects tones of all pitches. After months or years of the disease, hearing loss often becomes permanent. Tinnitus and fullness of the ear may come and go with changes in hearing, occur during or just before attacks, or be constant. Ménières disease is also called idiopathic endolymphatic hydrops and is one of the most common causes of dizziness originating in the inner ear. In most cases only one ear is involved, but both ears may be affected in about 15 percent of patients.

Ménières disease typically starts between the ages of 20 and 50 years. Men and women are affected in equal numbers. Because Ménières disease affects each person differently, your doctor will suggest strategies to help reduce your symptoms and will help you choose the treatment that is best for you. What are the causes? Although the cause is unknown, Menieres disease probably results from an abnormality in the volume of fluid in the inner ear. Too much fluid may accumulate either due to excess production or inadequate absorption. In some individuals, especially those with involvement of both ears, allergies or autoimmune disorders may play a role in producing Ménières disease. In some cases, other conditions may cause symptoms similar to those of Ménières disease. People with Ménières disease have a sick inner ear and are more sensitive to factors, such as fatigue and stress, that may influence the frequency of attacks. How is a diagnosis made? Your physician will take a history of the frequency, duration, severity, and character of your attacks, the duration of hearing loss or whether it has been changing, and whether you have had tinnitus or fullness in either or both ears.

When the history has been completed, diagnostic tests will check your hearing and balance functions. They may include: For hearing An audiometric examination (hearing test) typically indicates a sensory type of hearing loss in the affected ear. Speech discrimination (the patients ability to distinguish between words like sit and fit) is often diminished in the affected ear. For balance An ENG (electronystagmogram) may be performed to evaluate balance function. In a darkened room, eye movements are recorded as warm and cool water or air are gently introduced into each ear canal. Since the eyes and ears work in coordination through the nervous system, measurement of eye movements can be used to test the balance system. In about 50 percent of patients, the balance function is reduced in the affected ear. Rotational or balance platform testing, may also be performed to evaluate the balance system. Other tests Electrocochleography (ECoG) may indicate increased inner ear fluid pressure in some cases of Ménières disease.

The auditory brain stem response (ABR), a computerized test of the hearing nerves and brain pathways, computed tomography (CT), or magnetic resonance imaging (MRI) may be needed to rule out a tumor occurring on the hearing and balance nerve. Such tumors are rare, but they can cause symptoms similar to Ménières disease. What should I do during an attack of Ménières disease? Lie flat and still and focus on an unmoving object. Often people fall asleep while lying down and feel better when they awaken. How can I reduce the frequency of Ménières disease episodes? Avoid stress and excess salt ingestion, caffeine, smoking, and alcohol. Get regular sleep and eat properly. Remain physically active, but avoid excessive fatigue. Consult your otolaryngologist about other treatment options. How is Ménières disease treated? Although there is no cure for Ménières disease, the attacks of vertigo can be controlled in nearly all cases. Treatment may include: A low salt diet and a diuretic (water pill) Anti-vertigo medications Intratympanic injection with either gentamicin or dexamethasone.

An air pressure pulse generator Surgery Your otolaryngologist will help you choose the treatment that is best for you, as each has advantages and drawbacks. In many people, careful control of salt in the diet and the use of diuretics can control symptoms satisfactorily. Intratympanic injections involve injecting medication through the eardrum into the middle ear space where the ear bones reside. This treatment is done in the otolaryngologists office. The treatment includes either making a temporary opening in the eardrum or placing a tube in the eardrum. The drug may be administered once or several times. Medication injected may include gentamicin or corticosteroids. Gentamicin alleviates dizziness but also carries the possibility of increased hearing loss in the treated ear that may occur in some individuals. Corticosteroids do not cause worsening of hearing loss, but are less effective in alleviating the major dizzy spells. An air pressure pulse generatoris another option. This device is a mechanical pump that is applied to the persons ear canal for five minutes three times a day.

A ventilating tube must be first inserted through the eardrum to allow the pressure produced by the air pressure pulse generator to be transmitted across the round window membrane and change the pressure in the inner ear. The success rate of this device has been variable. When is surgery recommended? Surgery is needed in only a small minority of patients with Menieres disease. If vertigo attacks are not controlled by conservative measures and are disabling, one of the following surgical procedures might be recommended: Endolymphatic sac shunt or decompression procedure relieves attacks of vertigo in one-half to two-thirds of cases and the sensation of ear fullness is often improved. Control is often temporary. Endolymphatic sac surgery does not improve hearing, but only has a small risk of worsening it. Recovery time after this procedure is short compared to the other procedures. Selective vestibular neurectomy is a procedure in which the balance nerve is cut as it leaves the inner ear and goes to the brain. While vertigo attacks are permanently cured in a high percentage of cases, patients may continue to experience imbalance. Similar to endolymphatic sac procedures, hearing function is usually preserved.

Labryrinthectomy and eighth nerve section are procedures in which the balance and hearing mechanism in the inner ear are destroyed on one side. This is considered when the patient with Ménières disease has poor hearing in the affected ear. Labryrinthectomy and eighth nerve section result in the highest rates for control of vertigo attacks. Copyright © 2015 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly prohibited without prior written permission. Ménière's Disease-Topic Overview Ménière's Disease Credits What is Ménière's disease? Ménière's (say "men-YEERS") disease is an inner ear problem that affects your hearing and balance. It normally occurs in only one ear at a time. But over time, it develops in the other ear in up to half of those who have it. The disease usually occurs in people ages 40 to 60, but anyone can have it. What causes Ménière's disease? The cause of Ménière's disease is not known. But it may be related to a fluid called endolymph in the inner ear.

In people with Ménière's disease, too much of this fluid builds up. This creates pressure in the parts of your inner ear that control balance. Experts aren't sure why this fluid builds up. It may be that your body produces too much of the fluid. Or maybe the fluid doesn't drain as it should from the inner ear. Or it may be both. It's hard to predict who will get Ménière's disease. But your risk may be higher than normal if you have: Another family member who has it. Had a head injury , especially if it involved your ear. Had a viral infection of the inner ear. Allergies . What are the symptoms? Ménière's disease can cause symptoms that come on quickly and last from hours to days. During an attack, you may have: Vertigo , the feeling that you or your surroundings are spinning. This may last from minutes to hours. It may be bad enough to cause nausea and vomiting . Tinnitus , a low roaring, ringing, or hissing in your ear. Hearing loss , which may be temporary or permanent. A feeling of pressure or fullness in your ear. Most people have repeated attacks over a period of years.

Attacks usually happen more often during the first few years of the disease and then come less often after that. In some cases, each attack damages the inner ear. Over time your inner ear may become so badly damaged that it no longer works as it should. Then the attacks may stop, but you may be left with: Poor balance. Roaring or hissing in the affected ear. Continued A few people with Ménière's disease have "drop attacks." A drop attack is a sudden fall while you stand or walk. It occurs without warning. It may feel like you are suddenly being pushed to the ground. People who have these attacks don't pass out, and they recover within seconds or minutes. See a doctor right away if you think you have Ménière's disease. Prompt diagnosis and treatment may reduce both the discomfort of the attacks and your risk of hearing loss . How is Ménière's disease diagnosed? To diagnose the disease, your doctor will do a physical exam that includes checking your ears, eyes , and nervous system . The doctor will also ask questions about your past health and your symptoms, such as: How you feel when you have a vertigo attack. How long an attack usually lasts.

Whether anything seems to trigger an attack, like changing your position. Whether you have other symptoms along with vertigo, like hearing loss or nausea . Your doctor may also do tests to confirm a diagnosis of Ménière's. These tests may include: A Dix-Hallpike test to find out if certain head movements trigger vertigo. Hearing tests , including one to find out if the nerve from the inner ear to the brain is working as it should. A test called an electronystagmogram (ENG), which measures your eye movements. This can help the doctor find where the problem is that's causing vertigo. Imaging tests such as an MRI or CT scan of the head. These tests can find out if the symptoms are caused by a brain problem. How is it treated? Ménière's disease can't be cured. But your doctor can prescribe treatment to help control your symptoms and reduce how often you have attacks. Medicines Your doctor may prescribe a diuretic medicine. Diuretics help rid your body of excess fluid, so they may help prevent the buildup of fluid in your inner ear. And that may mean you have fewer attacks.

Your doctor may also prescribe medicines to use when you have an attack, such as: Medicines that reduce the vertigo. These include antihistamines such as dimenhydrinate (for example, Dramamine ), sedatives such as diazepam (for example, Valium ), and the scopolamine patch ( Transderm Scop). Medicines that reduce nausea and vomiting caused by vertigo. These are called antiemetics. Continued Other treatments If symptoms are severe and don't respond to medicine, your doctor may suggest another treatment, such as surgery to reduce the fluid or pressure in the inner ear. The goal is to get rid of your symptoms while saving as much of your hearing as possible. In rare cases of severe, lasting Ménière's disease, doctors may suggest a treatment to destroy the balance center in the inner ear (labyrinth), which can prevent vertigo. Options include: Surgery to remove the labyrinth. This is called labyrinthectomy. Chemical ablation. During this procedure, an antibiotic (usually gentamicin ) is injected into the inner ear to destroy the labyrinth. These treatments can cause permanent hearing loss, so they are usually done only as a last resort.

What can you do at home for Ménière's disease? Ménière's can be hard to manage and tough to live with. But there are some things you can do that may help reduce the number of attacks you have: Eat low-salt foods. Salt makes your body hold on to excess fluid. If you eat less salt, you may have less buildup of fluid in the ear. So you may get vertigo less often.

Question: Meniere’s disease affects which part of the body?
Answer: Inner ear