Published on November 6, 2024 at 8:00 / Updated on November 19, 2024 at 8:01

Ménière's disease is an inner ear disorder that affects balance and hearing. It takes its name from the doctor who first described it in 1861.

The ear has three components: the outer, middle, and inner ear. The outer ear is the part you can see. The middle ear is made up mainly of the ossicles, which are three small bones connected to the eardrum. Their vibration amplifies sound. The inner ear is filled with fluid and contains semicircular canals that help you keep your balance.

Ménière's disease is characterized by an excess of this fluid in the inner ear, which may be the result of an increase in fluid production or a decrease in drainage. This creates pressure and causes vertigo because the brain receives mixed signals, as if the person were standing up and lying down at the same time. The vertigo is accompanied by ringing in the ear and hearing loss. The combination of these three symptoms is also characteristic of Ménière's disease.

The first symptoms of Ménière's disease can manifest at any age, but generally appear between the ages of 20 and 50. Although it usually affects just one ear, in rare cases, the disease can spread to both.

Causes and triggers

The causes of Ménière's disease are still unknown. In some cases, it may simply be a blockage in the ear that is preventing fluid evacuation. Otherwise, risk factors include the following:

  • A reaction to a virus or bacteria
  • An allergy or immune dysregulation
  • A change linked to certain hormones
  • Chronic exposure to loud noises or sounds
  • Involuntary eye movements
  • Trauma of any kind
  • Intense stress

Symptoms

The symptoms of Ménière's disease often appear in the form of attacks, lasting anywhere from a few minutes to a few hours. Although sometimes preceded by a headache, these attacks are usually unpredictable. Their intensity and duration vary from person to person. For some they are infrequent and mild, while in extreme cases, they can be almost permanent. Attacks may involve the following symptoms:

  • Tinnitus (a continuous buzzing or ringing sound)
  • Dizziness and vertigo, which may result in:
    • Nausea or vomiting
    • Diarrhea and sweating
  • Headaches
  • Hearing loss (hypoacusis)
  • A feeling of pressure or pain in the affected ear
  • Stress (e.g., from not knowing when an attack will occur)

Hearing usually returns to normal between attacks. In some cases, tinnitus, headaches and dizziness persist for a few days. It's not unusual to feel tired after experiencing vertigo. As the attacks progress, the sensation of vertigo diminishes, but the balance issues remain. Most sufferers experience partial or total hearing loss in the affected ear within 10 to 15 years of experiencing their initial symptoms.

Treatment

While there is no cure for Ménière's disease, some treatments can help with its symptoms. There are medications available to alleviate dizziness and nausea. Others can help reduce the amount of fluid in the inner ear. More radical treatments may be used if symptoms become intolerable (e.g., middle ear injections, surgery).

Symptoms can also be reduced by adopting certain habits:

  • Sit or lie down when you feel dizzy
  • Take some time to rest after an attack (but don't wait too long to readjust your balance signals)
  • Take vertigo medication as soon as you feel an attack coming on
  • Limit your intake of salt, alcohol, coffee, and tobacco to avoid triggering an attack
  • Limit your exposure to loud noises or use protective equipment (earplugs, protective earmuffs)
  • Manage your stress levels with exercise and relaxation techniques
  • Use a hearing aid to help mitigate tinnitus and hearing loss

There are certain exercises you can do for what is known as vestibular rehabilitation. This involves reinforcing the complementary mechanisms involved in balance to counteract the effects of Ménière's disease on the inner ear. Note that in the case of Ménière's disease, vertigo is not caused by changes in position.

When should I see a health care professional?

Other diseases can cause the same symptoms, so it's important to figure out their root cause. Speak with your health care provider in the following cases:

  • You experience sudden dizziness on a regular basis
  • Your hearing fluctuates
  • You hear a constant ringing or buzzing
  • You feel pressure in your ear
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