Menieres Disease: Causes, Symptoms & Treatment

Sudden onset of dizziness may be harmless. However, if it occurs repeatedly and is accompanied by other symptoms, Meniere’s disease should be considered.

What is Ménière’s disease?

Balance disorders occur in Meniere’s disease combined with dizzy spells. Ménière’s disease, also called Meniere’s disease, is a disorder of the inner ear. It is manifested by attacks of vertigo lasting from 20 minutes to several hours. These can lead to severe nausea followed by vomiting. There is an additional reduction in the ability to hear in one ear, as well as a feeling of pressure and ringing or ringing in the ears similar to tinitus. Sometimes both ears can be affected. Drop attacks are considered a special manifestation of the disease. Here, the vertigo of Ménière’s disease is so pronounced that the patient loses orientation in the room and can fall severely as a result.

Causes

The causes of Meniere’s disease are largely unknown. However, the disease, which was described by the French physician Prosper Menière as early as the beginning of the 19th century and named after him, occurs more frequently in affected families, so that the presumption of inheritance of certain deviations in the shape of the auditory canals as well as the organ of equilibrium and the cochlea favors the disease. Ménière’s disease is thought to be triggered by a change in the fluid balance in the inner ear. The inner ear, in turn, consists of the organ of balance and the cochlea, which are connected by canals. These ducts contain the fluids endolymph and perilymph, which differ in their salt content. In Ménière’s disease, too much endolymph accumulates in the cochlea. It is not known whether this fluid can be inadequately absorbed by the body or whether too much is simply formed.

Symptoms, complaints, and signs

Ménière’s disease manifests itself in several symptoms that occur in attacks. Typically, the first attacks occur at night or in the morning. The most significant sign is dizziness. It comes on suddenly and completely without signs. It can last only a few minutes, but in isolated cases it can last up to several hours or days. The affected person feels as if he is standing on a turntable and perceives his surroundings as spinning rapidly around him. This can lead to nausea and vomiting. Often it gets so bad that the patient has to lie down. Accompanying this, noises in the ears and an unpleasant pressure in the ear become noticeable at the beginning of the attack, accompanied by hearing loss for low and medium-high tones. Often, only one ear is affected at first, but as the attack progresses, the symptoms spread to the other ear. The symptoms of the disease repeat at different intervals. There may be days, weeks, months or even years between attacks. Sometimes several attacks occur in succession at shorter intervals, followed by longer periods without symptoms. Stress can increase the frequency of attacks. During a Meniere’s attack, patients are usually pale and may sweat profusely. Uncontrolled eye tremor (nystagmus) also occurs in some cases.

Diagnosis and course

Ménière’s disease is generally diagnosed by an otolaryngologist. Important clues are the symptoms experienced, such as ringing in the ears and a feeling of pressure, as well as attacks of vertigo, which are typically described by the patient as “as if the ground were shaking” or “the environment is spinning.” In addition, hearing loss or hearing loss, especially in the low frequency range, is determined by a hearing test. With a special pair of glasses, the Frenzel glasses, it is possible to determine whether the patient suffers from trembling of the eyes. The tremor often makes it impossible to focus on a fixed point in space, which increases the feeling of dizziness. The diagnosis of Ménière’s disease is considered confirmed when at least two episodes of vertigo have occurred in addition to the other symptoms. The ringing in the ears and the feeling of pressure may persist beyond the attacks and worsen after each attack. Hearing also worsens in Ménière’s disease to the point of complete deafness of the ear.

Complications

As a result of Ménière’s disease, affected individuals usually suffer from vertigo that is permanent.This can also lead to headaches and a disturbance of coordination and concentration. In general, the patient’s quality of life is significantly reduced and limited by Ménière’s disease. Furthermore, the patient suffers from pallor and balance disorders or anxiety. It is not uncommon for those affected to suffer from tinnitus or strong and loud noises in the ears. However, without treatment, hearing loss and, in the worst case, deafness can also occur. It is not uncommon for those affected to sweat excessively and to be severely restricted in their daily lives by the symptoms. The dizziness itself can also lead to vomiting or nausea. Ménière’s disease is usually treated with bed rest and various medications. No particular complications or discomforts occur. In some cases, however, sufferers are dependent on a hearing aid. In most cases, life expectancy is not affected by Meniere’s disease.

When should you see a doctor?

Ménière’s disease is characterized by repeated episodes of vertigo. If the affected person suffers from incomprehensible dizziness several times, he or she should see a doctor. If the complaints lead to gait unsteadiness, general disturbances in motor function or increase the risk of injury and accidents, a doctor is needed. If the complaints increase in intensity or occur at increasingly shorter intervals, a visit to the doctor should be made as soon as possible. In many cases, repeated dizziness that lasts for only a few minutes is underestimated. Despite the seemingly minor or only short-term impairment of the affected person, a check-up with a doctor is highly recommended. Nausea and vomiting are further signs of an existing health disorder. If balance problems or hearing dysfunction occur, a doctor is needed. Ringing in the ears, a feeling of pressure in the ear, or decreased hearing ability should be investigated and treated. If the affected person suffers from emotional or physical stress, an increase in the complaints is to be expected. Therefore, accompanying psychological support is often helpful to alleviate the overall intensity of the symptoms. In case of persistent trembling of the eyelids, inner nervousness or restlessness, a doctor should also be consulted. In the case of headaches, deficits in concentration as well as attention and perceptual disturbances, a visit to the doctor is necessary.

Treatment and therapy

Treatment of Ménière’s disease first involves finding effective medications for the patient to dampen the seizures that occur. These include anti-nausea and anti-vomiting medications. There are also medications available that have an additional effect on the organ of balance. Which medications are effective must be tried on an individual basis. During an attack, the patient should stay in bed if possible to spare the organ of balance and prevent a fall. In acute seizures, improvement can be achieved by infusions that stimulate blood flow to the inner ear. Due to the increasing impairment of the hearing ability, the provision of a hearing aid becomes necessary. If the vertigo attacks become unbearable and none of the medications provide sufficient relief, surgery is possible to alleviate the symptoms. Saccotomy involves opening the inner ear to drain the fluid to the outside. In addition, other procedures are available for Ménière’s disease, but they are rarely performed or are performed only after the patient is completely deaf.

Outlook and prognosis

The prognosis of Ménière’s disease is favorable in most patients. When medical care is sought, drug treatment is initiated. In many cases, this can already lead to freedom from symptoms. Nevertheless, with the discontinuation of medication, health irregularities can develop again at any time. Therefore, it has to be examined individually how the further course will be or whether a long-term therapy is mandatory. In some patients, a surgical intervention is performed. In this operation the functional activity of the ear is optimized and thus the hearing ability is improved. This intervention is associated with risks and can lead to long-term health impairments in the event of disorders or complications.In case of an unfavorable course of the disease, hearing loss occurs. Without medical treatment, on the one hand, the risks of accidents increase and, on the other hand, deafness can occur. In a treatment the hearing ability is considerably improved by the use of a hearing aid. When making a prognosis, it should be taken into account that due to the adversities and stresses of the disease in everyday life, the risk of developing a secondary disease is increased. Patients often suffer from mental illness in the further course of the disease. This has a significant impact on the quality of life and can lead to a significant deterioration of the general condition.

Prevention

There is no active prevention of Ménière’s disease due to the unexplained cause of the condition. Affected patients can only lessen the force of their seizures by immediately taking medications to reduce dizziness and nausea, as well as vomiting. In addition, coffee, nicotine, and alcohol, as well as too much salt, should be avoided whenever possible to avoid provoking attacks of Ménière’s disease.

Aftercare

Ménière’s disease leads to various complications and complaints in the affected person and must therefore be treated and examined by a doctor in any case. In this regard, early detection and treatment of the disease has a very positive effect on the further course, so that the affected person should contact a doctor at the first symptoms. As a rule, Ménière’s disease cannot be cured on its own. In most cases, the affected person suffers from severe dizziness. This occurs without any particular reason and often does not disappear on its own. Furthermore, vomiting or severe nausea may also occur, so that the quality of life of the affected person is generally significantly reduced. In many cases, the disease also leads to hearing loss, so that especially children suffer from developmental discomfort. The development itself is slowed down, so that the child suffers from deficits and intellectual complaints at a later age. The complaints can occur especially in stressful situations and not infrequently also lead to depression or other psychological upsets. As a rule, however, the life expectancy of the affected person is not reduced by this disease.

What you can do yourself

There are several self-help options available to the sufferer of Ménière’s disease. As a rule, stimulants such as alcohol, coffee or nicotine should be avoided in order not to provoke the dizzy spells. High-salt foods can also have a negative effect on the course of the disease and should also be avoided. In the case of an acute attack, the symptoms can be alleviated with the help of medication. It makes sense to always have these medications on hand. If the affected person loses consciousness due to Ménière’s disease, an emergency physician should be notified. Until the emergency physician arrives, the affected person’s breathing should be controlled and the patient placed in a stable lateral position. In case of hearing difficulties, wearing a hearing aid is suitable. This can prevent further hearing loss due to loud noises. Furthermore, calm and steady breathing in stressful situations has a very positive effect on the disease. However, strenuous and stressful situations should generally be avoided. In the event of an acute attack, the affected person should get into a lying position and calm down. Massaging the head or temples can also combat the nausea or dizziness.