Ménière’s disease is a type of balance disorder. This complication is caused by a defect in a part of the inner ear called the labyrinth. Fluid accumulation in this area can cause severe dizziness and even affect hearing. Stay with us to learn the causes and symptoms of this condition and the new treatment for Meniere’s disease.
What is Meniere’s disease?
Meniere’s is one of the diseases of the inner ear, whose possible side effects are intermittent dizziness and hearing loss. In most cases, this disease is seen in only one ear. Meniere’s disease can occur at any age, but it is usually seen in people between 40 and 60. Although most people consider this disease to be a permanent condition, there are treatments to reduce its symptoms and long-term effects.
Causes of Meniere’s disease
In the inner ear is a part called the labyrinth, which houses the organs related to hearing and balance. This section has two features:
- bony labyrinth;
- Membrane labyrinth.
The membranous part of the labyrinth is preserved inside the bone and contains a liquid called endolymph. When the head moves, so do the endolymph. This causes the nerve receptors in the membranous labyrinth to transmit the body movement message to the brain. Excessive fluid accumulation in the maze can disrupt the regular transfer of balance and hearing messages between the inner ear and the brain. This causes Meniere’s disease.
Fluid accumulation usually occurs for the following reasons:
- allergy ;
- abnormal reaction of the immune system ( autoimmune disease );
- Abnormal discharge of fluid due to obstruction;
- head injury;
- genetic factors;
- Migraine headache ;
- Viral infection.
Of course, in most cases, several different factors cause this disease.
Symptoms of Meniere’s disease
The symptoms of this disease may appear suddenly and be seen during the day or now and then. Usually, one ear is involved, but symptoms may occur in both ears.
- Regular dizziness: The feeling of dizziness starts and ends suddenly. Dizziness may occur without warning signs and last from 20 minutes to 12 hours but will not last longer than 24 hours. Severe dizziness may accompany severe nausea, vomiting, and sweating.
- Hearing loss: This complication of Ménière’s disease occurs, especially in the early stages. However, over time, hearing loss may become permanent and not improve.
- Ringing in the ears: A person hears sounds such as ringing, buzzing, roaring, whistling, or hissing.
- The feeling of ear fullness: The pressure the patient feels in his ear is called ear fullness.
- Loss of balance.
- Headache.
- I do not hear low-frequency sounds.
After vertigo, symptoms may improve or even disappear for a while. Also, the number of attacks may decrease after some time.
Meniere’s diagnosis methods
The doctor examines the person and asks about his medical history to diagnose this disease. To diagnose Meniere’s disease, the following must be seen:
- Two or more vertigo attacks each for 20 minutes to 12 or a maximum of 24 hours;
- Confirmation of hearing loss with a hearing test;
- Ringing or fullness and pressure in the ear.
These tests are used to diagnose the disease:
- Hearing test. This test shows hearing changes caused by middle ear disease or other diseases.
- Balance test.
- MRI scan. It is used for tumor diagnosis.
- Electrocochleography (ECOG). This test measures the electrical activity of the inner ear.
These specialists may also examine the person:
- audiologist;
- otolaryngologist;
- Neurologist.
Hearing tests
A hearing test or audiometry (audiometry) shows the quality of hearing sounds with different intensities and sub-amplitude. It also confirms how well the patient notices the difference between similar words. People with Ménière’s disease usually have difficulty hearing low-frequency sounds or combinations of high and low frequencies. Of course, their hearing may be expected in medium frequencies.
Balance tests
Most people with Meniere’s balance return to average between vertigo attacks. Of course, some long-term balance problems may also occur. In the following, we have introduced tests that determine the proper functioning of the inner ear.
1. Electronystagmogram (ENG) or Videonystagmogram (VNG)
These tests examine balance through eye movement. In one part of the test, eye movement is checked when the eye follows a target, and in another part of this test, eye movement is limited when the head is in different positions. The third test, called the caloric test, examines eye movement simultaneously as the temperature changes to create a reaction in the inner ear. The doctor may use hot or cold air or water in the ears for this test.
2. Rotating chair test
This test also examines the function of the inner ear based on eye movement. To perform this test, a person sits in a computer-controlled chair, which rotates and stimulates the activity of the inner ear.
3. Recording of atrial evoked muscle potential (VEMP)
This test uses sound to activate parts of the inner ear and record the response of the muscles to that sound. Common changes may be seen in the ears of Meniere’s patients.
4. Computerized dynamic posturography (CDP)
This test shows which part of the balance system you rely on the most and which parts have problems. Components of the balance system include vision, inner ear function or skin senses, muscles, tendons, and joints. In this test, a person wears safety protection, stands on a bare-foot board, and maintains balance under various conditions.
5. Head video neuroimaging test (vHIT)
This test measures the coordination of the eyes with the inner ear. The vHIT test records the eye’s response to sudden movement using video. In this test, you focus on one point and move your head quickly and suddenly in different directions. You have an involuntary reaction disorder if you take your eyes off the target while turning your head.
6. Electrocochleography (EcoG)
This test examines the inner ear’s response to sound and is suitable for determining fluid accumulation. Of course, this test is not only used for Meniere’s disease.
Treatment of Meniere’s disease
There is currently no cure for Meniere’s disease. Some treatments can reduce the severity and duration of vertigo attacks, but there is no cure for permanent hearing loss. Of course, the doctor may suggest methods to prevent hearing loss and its worsening.
1. Anti-vertigo drugs
The doctor may prescribe drugs that reduce the severity of a vertigo attack, such as:
- Motion sickness medications: Medications such as meclizine or diazepam can reduce the feeling of dizziness and help control nausea and vomiting.
- Anti-nausea medications: Medications such as promethazine may reduce nausea and vomiting during a vertigo attack.
- Diuretics and betahistine: These drugs can be used alone or together to improve dizziness. Diuretics can reduce the body’s fluid, reducing excess fluid in the inner ear. Betahistines lessen the symptoms of vertigo by improving blood flow to the inner ear.
2. Long-term medications
Your doctor may prescribe medication to reduce fluid retention. This reduces the severity of Meniere’s disease symptoms in some patients.
3. Non-invasive treatments
In some people, the disease is treated with non-surgical methods such as:
- Rehabilitation: If patients have balance problems between vertigo attacks, vestibular rehabilitation therapy can improve their balance.
- Hearing aid: Placing a hearing aid in the ear of a person with Meniere’s disease can improve hearing. The doctor can refer the person to a hearing specialist to choose the right hearing aid.
4. Middle ear injections
Injecting the drug and absorbing it in the middle ear improves the symptoms of dizziness. This treatment is performed in the doctor’s office and includes the injection of these drugs:
- Gentamicin: This antibiotic is toxic to the inner ear and destroys the diseased part of the ear, causing dizziness. The duties of the sick ear will be to balance the shoulders of the healthy ear. Of course, there is a risk of hearing loss.
- Steroids: Steroids such as dexamethasone can suppress vertigo attacks in some people. Of course, this drug is less effective than gentamicin, but it causes less hearing loss.
5. surgery
If the vertigo attacks from Meniere’s disease are severe and unbearable and other treatments don’t help, your doctor may recommend surgery. Surgeries to treat this disease include:
- Endolymphatic sac surgery. The endolymphatic sac helps control the amount of middle ear fluid. This surgery reduces the pressure around the endolymph bag, which can regulate the amount of liquid. Sometimes the doctor puts a tube in the ear to drain the excess liquid.
- Surgery to remove the labyrinth (labyrinthectomy). In this procedure, the surgeon removes some parts of the ear that cause vertigo. This causes a complete loss of hearing in that ear. This surgery makes the healthy ear responsible for sending balance and hearing information to the brain. The doctor usually suggests this surgery when the patient’s ear is hard of hearing or completely deaf.
- Vestibular nerve surgery. This procedure involves cutting the vestibular nerve to block the path of motor information to the brain. The vestibular nerve conveys balance and movement information from the inner ear to the brain. This operation usually improves vertigo and preserves the patient’s hearing. This surgery is performed under general anesthesia and with an overnight stay in the hospital.
Lifestyle changes and home treatment of Meniere’s disease
By following a few simple tips, you can improve some of the symptoms of Meniere’s disease. When experiencing a vertigo attack, keep these things in mind:
- If you feel dizzy, sit or lie down. Avoid activities that worsen your symptoms, such as sudden movements, bright lights, watching TV, or reading books. Focus your attention on an object that is not moving.
- Rest during and after the attack. Do not rush to return to your normal activities. If you are tired, rest briefly, and slowly get up and move when you can. This helps the brain reset the balance messages.
- Prepare yourself before the vertigo attack. Talk to your doctor about how to prepare. Ask about medication for dizziness, when to go to the hospital, and injury prevention methods.
Lifestyle changes
To prevent a vertigo attack, follow these tips:
- Consume less salt. Eating foods and drinks with a lot of salt can cause water retention in the body. Consuming less than 2,300 milligrams of salt daily is best to maintain your overall health. Also, experts suggest that you spread the consumption of this amount of salt throughout the day.
- Limit caffeine, alcohol, and tobacco consumption. These substances can cause dizziness in some people. Try to make a list of your symptoms and find their possible causes.
Common questions
1. What is Meniere’s disease, and how is it caused?
Meniere’s is caused by fluid accumulation in the inner ear canals. This disease may cause dizziness, nausea, vomiting, hearing loss, ear ringing, headache, loss of balance, and sweating. Usually, a combination of different factors causes Meniere’s disease, including allergies, autoimmune reactions, head trauma, blockage of the ear fluid drain, genetics, migraine headaches, and viral infections.
2. What people are more affected by this disease?
Anyone can develop Meniere’s disease. Of course, this complication is more common in people aged 40 to 50.
3. Is there a cure for Meniere’s disease?
There is still no definitive cure for this disease, but some treatment methods can help improve the symptoms. Standard treatment methods for Meniere’s syndrome include surgery, taking medicine or injecting it into the inner ear, changing diet, and using hearing aids.
4. What are the long-term effects of this disease?
One of the most common symptoms of Meniere’s disease is dizziness. This symptom can cause falls, difficulty driving, and interference with other normal daily activities. It can also cause permanent deafness. These problems may lead to depression and anxiety or make it difficult to work and socialize with family or friends.
final word
Various factors may cause Meniere’s disease, which still has no specific treatment. Of course, the patient can go to the doctor and receive appropriate drugs to control the symptoms or, if necessary, take advantage of more aggressive treatments to improve his quality of life. Lifestyle changes, diet, and using a few simple home remedies may also significantly reduce symptoms and slow the progression of the disease.
Warning! This article is only for educational purposes; to use it, it is necessary to consult a doctor or specialist.
