Meniere's Disease: Symptoms, Causes and Treatment

Meniere's disease is named after French physician Prosper Ménière, who first described the syndrome in 1861. This disease often results in loss of hearing, although it usually affects only one ear. Meniere's manifests as an abnormality of the inner ear indicating its existence through vertigo, severe dizziness, tinnitus (a roaring sound in the ears), fluctuating hearing loss, and the sensation of pressure or pain in the affected ear.

Causes

There exists a portion in the inner ear known as the labyrinth, within which fluid is contained. The labyrinth has two parts: the membranous labyrinth and the bony labyrinth. The membranous labyrinth, required for hearing and balance, is encased by bone and filled with a fluid called endolymph. When we move our heads, the endolymph fluid moves, causing nerve receptors in the membranous labyrinth to send signals to the brain about the body's motion. An increase in endolymph, however, can cause the membranous labyrinth to balloon or dilate. This condition is known as endolymphatic hydrops.

Perilymph, is another fluid that occupies the space between the membranous labyrinth and the bony inner ear. It is the belief of many experts on Meniere's disease, that a rupture of the membranous labyrinth allows the endolymph to mix with perilymph. Accordingly, this results in the symptoms of Meniere's disease. Nonetheless, the exact cause of Meniere's disease remains unknown. In some cases, a connection exits between the onset of the illness and recently suffered head injury, middle ear infection or syphilis. Other factors that increase risk include allergies, alcoholism, fatigue, recent viral illness, respiratory infection, smoking, stress, and use of certain medications including aspirin. It is possible that genetics also plays a role in acquiring this disease.

Multiple investigations into the possible causes of the disease are being carried out. Among factors under the microscope are environmental factors such as noise pollution and viral infections, as well as biological factors.

Symptoms

The symptoms of Meniere's disease occur suddenly. Its unpredictable symptoms can be experienced everyday or as rarely as once a year. In some patients, symptoms start with tinnitus, which is a sensation of a ringing, roaring, or buzzing sound in the ears or head. Following this, they may experience diminished hearing or a build up of pressure in the affected ear. One of the worst symptom of Meniere's disease is vertigo, which is dizziness accompanied with a rotating feeling that forces the person to lie down. Vertigo attacks can lead to severe nausea, vomiting and sweating, and often come with little or no warning.

The most commonly experienced attack of Meniere's disease lasts for several hours and is characterized by a combination of vertigo, tinnitus and hearing loss. The intensity, frequency and duration of an attack defers from person to person. The lucky ones may experience vertigo only a few times a year, or be faced with intense tinnitus while sleeping. Others may suffer hearing loss and feel unsteady for extended periods of time. A person's hearing usually recovers between attacks but over time can becomes worse. Occasional symptoms of Meniere's disease include headaches, abdominal discomfort and diarrhea.

Treatment

There is no cure for Meniere's disease. The goal of treatment is to reduce pressure in the inner ear and relieve symptoms. This is at times achieved through dietary changes (such as a low-salt or salt-free diet and no caffeine or alcohol) or medication. Medication to control allergies or improve blood circulation in the inner ear may help. Water pills (diuretics) that can relieve fluid pressure in the inner ear could also help. Lifestyle changes such as reducing stress levels and stopping the intake of tobacco have also proved effective in managing symptoms.

Certain surgical procedures are also recommended for patients with persistent, debilitating vertigo. A procedure of the removal of the inner ear sense organ called Labyrinthectomy can effectively control vertigo. However, this procedure sacrifices hearing and is reserved for patients with non-functional hearing in the affected ear. Another option, Vestibular neurectomy involves selectively severing a nerve from the affected inner ear organ and usually controls the vertigo while preserving hearing, but carries surgical risks. In recent times, an option that is gaining popularity is the administration of the ototoxic antibiotic - gentamycin directly into the middle ear space. It helps control the vertigo of Meniere's disease

Approximately 0.2% of the population in the US are affected with Meniere's disease. There is no known prevention, but prompt treatment of ear infections and other related disorders may be the best way to avoid Meniere's disease.