By Dr Ananya Mandal, MD
Ménière's disease is a disorder that affects the inner part of the ear. It leads to symptoms of:
Patients often also complain of a feeling of pressure in their ears. The disease manifests itself in attacks that may appear suddenly and without warning. These attacks may last around 2-3 hours. The symptoms may take 1-2 days to disappear fully. Symptoms differ widely from person to person. (1-6)
Cause of Ménière's disease
Ménière's disease is a disorder of the inner ear that occurs due to change in fluid volume in the labyrinth in the inner ear. Ménière’s Disease is named for the Frenchman Prosper Ménière who first described the syndrome in the mid 1800’s.
Deep within the ear lies a shell shaped organ called the cochlea that helps in hearing and the vestibular apparatus that helps in balance. The vestibular apparatus is a set of thin tubes set perpendicular to each other. These are called the membranous labyrinth.
The membranous labyrinth contains fluid called endolymph. In Ménière's disease there is a change in the endolymph and there is a progressive distension.
It is also called “endolymphatic hydrops”. This swelling and change may affect the cochlea causing hearing loss or the vestibular apparatus causing dizziness and balance problems.
Symptoms of Ménière's disease
Some people with Ménière’s disease have dizziness or vertigo so extreme that they may lose their balance and fall. These episodes are called “drop attacks.”
The disease affects the inner ear and progresses through different stages. In the early stages a patient usually has around 6-11 attacks a year. As the disease progresses the frequency of attacks reduces and they eventually stop.
Symptoms usually disappear on their own after 2-8 years. Some people may however continue to have a permanent hearing loss affecting one or both ears and the problem of tinnitus may also continue.
Frequency of Ménière's disease
Ménière's disease is diagnosed in around one in 1,000 people in the United Kingdom and is seen in 157 individuals per 100,000 population.
According to the estimates from the National Institute on Deafness and Other Communication Disorders (NIDCD) approximately 615,000 individuals in the United States are currently diagnosed with Ménière’s disease and 45,500 cases are newly diagnosed each year.
Who is affected by Ménière's disease?
It may affect all age groups but is commonly seen in people aged between 40 and 60. Ménière's disease is slightly more common in women than in men. The condition mostly affects Caucasians.
It's not possible to prevent the disease. In many patients there is a history of the disease running in the family suggesting a genetic origin of the disease.
Diagnosis of Ménière's disease
Diagnosis is based on clinical features, laboratory findings and hearing tests (audiometry findings) and by ruling out other ear disorders.
Treatment of Ménière's disease
Ménière's disease can be treated using various medications. These allow most people with the disease to live a more normal life.
During an attack a patient is asked to lie still and avoid noise using ear plugs. Medication can be prescribed to relieve nausea and vertigo during this time.
Other drugs include Antihistamines or diuretics (water pills) that help in reducing the frequency of attacks.
There are other therapeutic approaches that can help with the tinnitus and balance problems in these patients.
Patients are advised to avoid stress, and take a low-salt diet. Surgery may also be recommended as a last resort.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)