What You Need to Know About Menière’s Disease

Menière’s disease is an inner-ear condition with symptoms including balance problems, deafness, headaches, nausea, sweating, tinnitus, vertigo and vomiting. We don’t know its exact cause, but it’s related to fluid imbalances in the ear canals.

While it is currently incurable, the good news is that it’s manageable. Treatments include behavioural therapies, dietary changes, hearing aids, medication and surgery (to treat balance problems).

Here’s further information.

What Causes Menière's Disease?

Menière’s disease (named in the 1800s after the French physician Prosper Menière) typically affects only one ear, though it may affect both over time. Its causes are poorly understood, but we know the inner ear’s fluids are affected. These fluids move through the three canals (superior, posterior and horizontal) that provide our sense of balance and position in space. 

In Menière’s sufferers, these fluids’ volumes and concentrations of sodium, potassium and chloride vary from their regular levels, fluctuating with the body’s fluid levels and disrupting the balance and hearing systems.¹ Over time, these fluctuations can cause irreversible damage to the sensory cells lining the canals.

Symptoms of Menière's Disease

Menière’s disease typically manifests irregularly, with symptoms including vertigo, loss of balance, nausea, vomiting and deafness. Attacks can occur suddenly or may be preceded by warning symptoms, including earache, tinnitus, hearing abnormalities, or a feeling of pressure in the ear.²

It’s common for sufferers to feel exhausted after an attack. Over time, attacks can become less frequent and severe, but some symptoms, including balance problems and hearing loss, may become permanent.

Menière's Disease and Deafness

Deafness is among the main symptoms of Menière’s disease. In most cases, hearing loss only affects one ear. In its early stages, deafness only occurs during the attack and disappears afterwards. Prolonged illness, however, often results in permanent sensorineural hearing loss.³ 

Menière’s disease most often causes deafness affecting the ability to hear deep tones. However, treatments and mitigations are available to reduce the impact of any hearing loss. 

Diagnosing Menière's Disease

Diagnosing Menière’s can be challenging, as its symptoms are not unique. Patients may need a hearing test (to detect any changes in the middle ear), balance test, MRI (to determine if any tumours are present) or electrocochleography (ECOG, to measure the inner ear’s electrical activity).⁴

Diagnosis may require you to visit an audiologist, neurologist or ENT (ear, nose and throat) specialist, as your local GP is unlikely to have the necessary diagnostic procedures and tools available.

Treating Menière's Disease

As noted, there is no cure for Menière’s disease, but it can be treated with:⁵

• Middle ear injections: antibiotics or steroids may be injected into the middle ear to help treat vertigo symptoms.
• Surgery: procedures to drain excess fluid, cut nerves or even remove parts of the inner ear can help resolve vertigo attacks. 
• Medicines: anti-nausea and motion sickness medications can relieve vertigo symptoms, as can diuretics and betahistine.

Living with Menière's Disease

Since the causes of Menière’s disease are not fully known, there are no specific measures to prevent it or treat an occurrence. However, it is possible to manage the condition and mitigate its effects. Many sufferers of Menière’s find that balance training, exercise and relaxation help them manage their condition, even though there is no scientific evidence to back their position.

Once diagnosed, leading a healthy lifestyle is recommended. Beneficial changes may include: 

• No smoking.
• Eating a low-sodium, high-potassium diet.
• Limiting caffeine and alcohol consumption.
• Avoiding stress.

The best thing you can do to protect yourself against Menière’s Disease is to keep track of any symptoms in a diary, calendar, notebook, or notes app on your mobile device.
Visit your Connect Hearing clinic if you have any concerns about your hearing health. The team can diagnose, treat and help you manage your condition, no matter how early or advanced it may be.

References:

1. Royal Victorian Eye and Ear Hospital [17 February 2023], Meniere’s Disease, Royal Victorian Eye and Ear Hospital, accessed 28 May 2024. 
2. Healthdirect [July 2022], Menière’s disease, Department of Health and Aged Care, accessed 20 May 2024.
3. Cleveland Clinic [11 April 2024], Menière’s Disease, Cleveland Clinic, accessed 28 May 2024.
4. Johns Hopkins Medicine [n.d.], Meniere Disease, Johns Hopkins Medicine, accessed 28 May 2024. 
5. Mayo Clinic [3 January 2024], Meniere’s disease, Mayo Clinic, accessed 28 May 2024.