Meniere's Disease

  • Meniere’s disease is a condition of the inner ear. It is also known as ‘Endolymphatic Hydrops’ and is caused by abnormal fluid collections in your balance organs (semicircular canals) and hearing organ (cochlea).

  • About 1 in 1000 people develop Meniere’s disease. It can affect anyone at any age but most commonly begins between the ages of 40 and 60. Generally, this condition starts in one ear only. The other ear is also affected in about 4 in 10 cases. The cause of this disorder is not known.

  • What Are The Symptoms of Meniere’s Disease?
  • 1. Vertigo: A feeling of movement when you are still. You feel as though the room is spinning and you lose your balance. These episodes can occur without warning and usually last 20 minutes to 2 hours or more. You may also experience severe nausea, vomiting and sweating.
  • 2. Tinnitus: A ringing, buzzing, whistling, hissing or roaring sound in the ear. Tinnitus may get louder as the disease progresses.
  • 3. Aural Fullness: A ‘full’ feeling, or pressure in the affected ear.
  • 4. Hearing Loss: Tends to come and go in the early stages but some people may experience a degree of permanent hearing loss. Usually in the lower tones.

  • What Can I Expect During a Meniere’s Attack?
  • If you have Meniere’s disease, you will have intermittent ‘attacks’ of vertigo, hearing loss, ringing and fullness of the ear that can vary in frequency and length. On average, an attack lasts 2-4 hours. Following an attack, you may feel very tired.

  • Meniere’s episodes may also occur in clusters (several attacks that occur within a short period of time). Between acute attacks, most people are free of symptoms or note only mild imbalance and tinnitus problems. Years may pass between episodes. The disease is very unpredictable.

  • Cochlear Hydrops and Vestibular Hydrops
  • Sometimes Meniere’s Disease can occur without vertigo. In this type of disorder, the fluid imbalance is limited to the cochlea (the hearing organ). In other patients, episodic vertigo without hearing loss may occur in which case only the vestibular system is affected.

  • Tracking Your Attacks
  • You should know that not everyone experiences Meniere’s attacks in the same way. You should keep a detailed diary of all of your attacks and include this information:

  • • When the attack happened – What day? At what time? What were you doing at the time of the attack?
  • • The length of time the acute attack lasts
  • • Symptoms that come with the attach (spinning, headache, tinnitus, pressure, fullness, hearing loss)
  • • How you felt after the attack – how long did this feeling last?
  • • Did you take any medications to help you?

  • By tracking your attacks, your doctor will have a better understanding of how Meniere’s disease affects you, and then make decisions on how to best help you deal with it.

  • How is Meniere’s Disease Treated?
  • There is no cure for Meniere’s disease, but there are a number of things that can be done to help you manage some of your symptoms. It is often treated in a 'step-wise' approach.

  • The first step is by making lifestyle changes:
  • - Follow a ‘low-salt’ (sodium) or ‘salt-free diet’. Less than 1500-2000 mg per day. This will help to reduce your inner ear fluid pressure.
  • - Try to avoid caffeine, smoking and alcohol.
  • - Try your best to get regular sleep. Stay active and avoid excessive fatigue.
  • - Reduce your stress the best you can as this is a known trigger.
  • - Avoid Aspirin, ibuprofen and other NSAIDS.

  • You may be started on a diuretic or ‘water pill’ to help reduce your inner ear fluid pressure.
  • You may try taking medications to help with the vertigo, nausea and vomiting. This may include a benzodiazepine (lorazepam/Ativan) that can be used during an acute attack, or betahistine (Serc) that can sometimes help with dizziness.
  • Often times, vestibular rehabilitation therapy may be needed. This can be done through a physiotherapy office that specializes in specific exercises and activities that can help your body and brain to regain the ability to process balance information correctly.
  • For severe situations, intra-tympanic injections (anti-inflammatory medication placed behind the ear drum) with steroids may be offered.
  • In rare cases, a chemical or surgical labyrinthectomy (destroying the vestibular system) may be necessary.

  • As with any chronic disorder, maintaining a healthy outlook and as normal a routine as possible is essential. Creating a safe physical environment in the home is also important, as well as taking into consideration whether one should undertake potentially hazardous activities such as driving a car, climbing ladders, or participating in sports.

  • The available evidence suggests a period of frequent episodes in the one to two years following onset. After that two year period, there is a 50/50 chance that episodes will most likely decrease in frequency and may actually resolve or reduce enough that invasive procedures may not be necessary.