By Dr Ananya Mandal, MD
Ménière's disease is a disease of the inner ears that affects the endolymphatic fluid pressure within the deeper parts of the ear responsible for balance and hearing functions. Symptoms usually affect these functions and may vary from person to person.
Attacks may occur without warning and may be sudden and severe. (1-6)
Main symptoms of Ménière's disease
The important symptoms of the condition that vary in severity in different individuals include vertigo, tinnitus and so forth.
Vertigo and Ménière's disease
There is severe dizziness in most patients. This occurs due to the pressure inside the membranous labyrinth and the vestibular apparatus.
Dizziness is most commonly accompanied by other balance problems. Patients often complain of the environment around them that is moving or spinning causing them to fall.
Severe vertigo that results in falls are called “drop attacks”. This is reported in about 4% of Ménière's disease patients.
Vertigo is the most common and noticeable symptoms of Ménière's disease. The attacks of vertigo may last for a few minutes to up to 2 to 3 hours at a time.
Along with vertigo there are associated physical symptoms like nausea, vomiting, sweating, diarrhoea and/or palpitations or rapid pulse rates.
Tinnitus and Ménière's disease
Tinnitus is defined as the feeling of a background noise in one or both ears or in the head where there is no outside source of the noise.
The noise may be a low humming, ringing, buzzing, whooshing or clicking sound. It can be very disturbing and often interferes with sleep and concentration.
Loss of hearing
This can affect one or both ears. The loss of hearing usually affects low pitched sounds first.
Pressure in the ear
There may be a sense of pressure or fullness deep inside the ear
Effect of symptoms of Ménière's disease on daily life
The effects of the condition in the activities of daily life are profound. The condition can sometimes affect work and family life. Those who operate heavy machinery, drive or work at heights find it difficult to hold onto their jobs for example.
Hearing loss also affects social, family as well as work life.
Tinnitus interferes with sleep and also with the ability to concentrate. There may be other associated problems in Menière's disease like anxiety disorders and depressive illness.
Progression of disease symptoms
The disease progresses in stages. There are three common phases or stages of the disease. These include the early, middle and late stage. All patients do not pass through each of these stages.
Early stage Ménière's disease symptoms
The early stages are characterized by more frequent attacks and as the attacks decrease in frequency, the hearing loss becomes progressively worse.
The early stage is characterized by sudden and unpredictable attacks of vertigo along with features like nausea and vomiting. There is a pressure feeling in the ears and loss of hearing during the attack.
The attacks may last for half an hour to up to 24 hours. They commonly last around 2-3 hours.
It is estimated that most people experience 6 to 11 attacks a year. Between attacks there are usually no symptoms of the condition.
Middle stage Ménière's disease symptoms
In the middle stage the attacks continue but the severity declines. Tinnitus and hearing loss often become worse. There may be several months between two attacks at this stage.
Late stage Ménière's disease symptoms
During the late stage of Menière's disease the attacks occur very rarely. However, there are other persistent problems like balance difficulties and hearing loss.
Patients find it difficult to walk in the dark. Tinnitus also worsens. The longer the condition lasts, the more likely it is to affects both ears. Around 40% people have both ears affected during the late stage of the disease.
Reviewed by April Cashin-Garbutt, BA hons (Cantab)
Last Updated: Aug 7, 2012