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Meniere’s Disease: Causes, Symptoms, Treatment And Prevention

Meniere’s Disease is a disorder of inner ear that causes balance and hearing problems. It is more likely to affect people between the age of 20 to 50 years. This condition is considered chronic, but various treatments can ease symptoms.

Meniere's Disease

Meniere’s disease affects 12 out of 1,000 people in the world. Around 100,000 people develop this disease every year.

What is Meniere’s Disease?

It is the disorder of the membranous labyrinth of the inner ear, which is often accompanied by vertigo (spinning sensation), deafness, and tinnitus (ringing sound).  It mostly affects one ear and is a common cause of loss of hearing. The episodes of Meniere’s disease last from 20 minutes to few hours.

What are the Causes of Meniere’s Disease?

The cause of Meniere’s disease is not clearly understood. There are theories given to explain the cause of this condition. One such theory, explains that accumulation of fluid (endolymph) in the inner ear can cause Meniere’s disease, but it didn’t explain the reason for this accumulation.

Certain environmental, genetic, autoimmune and allergy factors have also been implicated as a cause of this condition.

What are the Symptoms of Meniere’s Disease?

The symptoms of Meniere’s disease include:

  • Recurring vertigo (spinning sensation) episodes that last for few minutes to 24 hours
  • Loss of hearing in the affected ear
  • Sensation of ringing (tinnitus) in the affected ear
  • Loss of balance, headaches
  • Aural fullness, a feeling of ear fullness and pressure is applied to it
  • Nausea, vomiting and sweating, are due to severe vertigo

What are the Risk Factors of Meniere’s Disease?

Factors that may contribute to Meniere’s disease include:

  • A family history of Meniere’s disease
  • Pre-existing autoimmune disorders
  • Allergies
  • Head and ear trauma
  • Genetic predisposition
  • Migraine
  • Viral infection
  • Improper fluid drainage, due to anatomic abnormality and blockage

What are the Complications of Meniere’s disease?

Some of the complications of Meniere’s disease include:

  • Unpredictable episodes of vertigo
  • Permanent hearing loss
  • Fatigue
  • Emotional stress
  • Anxiety
  • Depression
  • Vertigo can lead to loss of balance, increases the risk of sudden falling and accidents.

How to Diagnose Meniere’s Disease?

The diagnosis of Meniere’s disease requires:

  • At least two episodes of vertigo, lasting for 20 minutes or more but no longer than 24 hours
  • Hearing loss (Deafness) verified by a hearing test
  • Feeling of fullness (Tinnitus) in the ear

Tests that are required to confirm the diagnosis are:

Hearing Test

A hearing test or audiometry is used to detect hearing loss in a person. In this test, headphones are kept at person’s ears, and variety of sounds with different pitches and volumes are played. If a person is not able to hear any sound clearlyor differentiate between any two similar sounds, then the person is considered to be deaf.

Balance Assessment

Inner ear is responsible for maintaining balance. The following tests help in assessing the balance of an individual:

  • Videonystagmography (VNG): This test helps to find if the abnormal eye movements contribute to balance defects.
  • Rotatory-chair testing:This test helps to find if the abnormal eye movements contribute to balance defects.
  • Posturography: It reveals which part of balance system (vision, inner ear etc.) may cause the problem.
  • Video head impulse test (VHIT): This test uses video to measure eye reactions to abrupt movements.
  • Electrocochleography:This test helps in looking at the inner ear in response to sound. It checks for any abnormal fluid build-up in the inner ear, but it is not specific for Meniere’s disease.

Other Tests include:

  • Testing for Multiple sclerosis or brain tumours
  • Head MRI helps in visualizing the inner ear and check for any serious illness. It is useful during early stages of the disease.

What is the Treatment for Meniere’s Disease?

Meniere’s disease is a chronic condition that has no cure. However, there is number of treatments that help to reduce the symptoms and episodes of vertigo. No treatment is available for loss of hearing with Meniere’s disease.

Medications for Vertigo:

Medicines for vertigo can reduce the severity of an attack. It includes:

  • Motion Sickness Medications: These medications can ease symptoms of vertigo, nausea and vomiting. Meclizine and diazepam (Valium) are some medications for managing motion sickness.
  • Anti-nausea Medications: If nausea and vomiting are severe, anti-nausea medications are prescribed, such as Promethazine.
  • Diuretics: It is useful to reduce any abnormal fluid build-up in the inner ear.

Non-invasive Therapies:

  • Rehabilitation: The vestibular rehabilitation therapy can help to improve balance when there is an imbalance between episodes of vertigo.
  • Hearing Aid: A hearing aid is a device that is fitted on an ear to aid in hearing. An audiologist can treat hearing loss by using the hearing aid.
  • Meniett Device: When vertigo becomes severe to treat, a meniett device is used to apply pressure on the middle ear that helps in fluid exchange.

Middle Ear Injections:

Gentamycin and steroids are the middle ear injections that help to improve vertigo symptoms.

Surgery:

In case of severe vertigo attacks associated with Meniere’s disease, surgery can be an option. It includes:

  • Endolymphatic sac procedure:This procedure helps in reducing fluid production and increase fluid absorption, thereby reduces vertigo.
  • Vestibular nerve section: This procedure involves cutting of vestibular nerve that connects the balance and movement sensors.
  • Labyrinthectomy: It is the removal of the portion of the inner ear that controls balance.

What are the Methods of Prevention of Meniere’s Disease?

Some measures that can help in reducing the severity of the symptoms of Meniere’s disease are:

  1. Resting during vertigo attacks.
  2. Eating regularly that helps to regulate fluids in the body.
  3. Managing stress and anxiety through psychotherapy and medications.
  4. Avoiding vehicle driving and operating heavy machinery, can reduce accidents and sudden fall due to vertigo attack.
  5. Quitting smoking, as nicotine in tobacco can worsen the condition.
  6. Limiting salt, caffeine, alcohol and monosodium glutamate (MSG) intake, can reduce the amount of fluid in the inner ear and can ease symptoms.
  7. Drinking six to eight glasses of water regularly can reduce the loss of fluids from the body.

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