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Meniere’s disease is an ear condition that is chronic and causes vertigo, ringing in the ears (tinnitus), hearing loss, and a feeling of fullness in the ear. The cause of Meniere’s disease is unknown, but it is an inner ear disease, believed to be caused by an abnormality in the fluids of the inner ear. Meniere’s disease can be unpredictable and often it takes time to be diagnosed. Symptoms can be quite severe, may happen all of a sudden, and last for a long period. Some individuals with Meniere’s disease may experience several to multiple symptoms daily and also go several months to a year without any symptoms. The symptoms will vary from person to person however having Meniere’s disease might not mean having all the classic symptoms all at once. 

What is Meant by Meniere's Disease

Meniere's Disease is an abnormality of the inner ear causing a host of symptoms. These symptoms include vertigo, tinnitus, hearing loss, and the sensation of fullness in the affected ear. The underlying cause of the disease is unknown, but medical professionals have made a connection between the disease and fluid imbalance in the inner ear. The symptoms of the disease can appear out of nowhere and can last up to a few hours. Most cases of Meniere's disease will vary in intensity. 

What Causes Meniere's Disease?

The cause of Meniere's Disease is not fully understood. However, most researchers think that it results from an abnormality in the fluid that the inner ear uses to maintain balance. It's called endolymph. The factors that contribute to or can trigger Meniere's can include:

  • Improper fluid drainage may occur when the channels connecting compartments of the inner ear are blocked or there is an anatomic abnormality.
  • Diseases, such as viral infections in the inner ear, or the presence of autoantibodies.
  • Genetic predisposition, as it can run in families.
  • There may be a role for allergies in some people.
  • Head injury or migraines can sometimes be associated with the onset.
  • Immune system response or autoimmune reactions.

What are the Symptoms of Meniere's Disease?

Meniere's Disease produces a set of primary symptoms that may vary in intensity and can occur suddenly. Such symptoms include:

  • Vertigo: Vertigo is the defining symptom of Meniere's disease. It's a spinning feeling that could make you feel queasy or even sick. Vertigo attacks can last anywhere from a few minutes to many hours. After a severe episode, some people may continue to have residual vertigo for days.
  • Hearing loss: In the early stages, fluctuating hearing loss is typical; between episodes, it frequently returns to normal or a close to normal level. Some people may develop persistent hearing loss over time.
  • Tinnitus: A ringing, buzzing, roaring, hissing, or whistling sound in the ear is referred to as tinnitus.
  • The feeling of pressure or fullness: This usually occurs in one ear. This feeling could come before or after an episode.
  • Balance issues: Some people may experience balance issues in between episodes of vertigo.

How is Meniere's Disease Diagnosed?

Diagnosing Meniere's Disease can be a bit difficult because some symptoms are similar to those of other conditions. There is no single test that is a definitive yes or no for this disease. Diagnosis usually involves gradually ruling out other problems, followed by any of several tests suggested by a health care professional:

  • Medical History Review: Discussing the symptoms, the time, and the duration: The doctor should know how often the vertigo attacks occurred, whether their intensity was severe or mild, and if there was any hearing loss or ringing sound in the days when it occurred.
  • Physical Examination: It is important to examine the ear but, also to check other systems that could be causing the disease.
  • Audiology (Hearing) Test: This will usually consist of a hearing test called an audiogram (A graphic representation of the relation of vibration frequency of a sound to the amplitude of the vibration necessary to produce a certain loudness.) that measures hearing at different frequencies.
  • Balance Tests: The balance function can be evaluated by balance tests like electronystagmography (ENG) or videonystagmography (VNG). These evaluate the inner ear by measuring involuntary eye movements (called nystagmus) that are provoked by stimulating the inner ear.
  • Magnetic Resonance Imaging (MRI) or Computed Tomography Scan (CT): These tests are used to rule out other causes of dizziness, such as a tumor or a structural abnormality.
  • Electrocochleography (ECOG): Electrocochleography or ECOG is a test that measures the electrical activity in the inner ear (cochlea).
  • Vestibular Evoked Myogenic Potential (VEMP) Testing: This test is useful in differentiating Meniere’s disease from other inner ear conditions. This test measures the sound sensitivity of the vestibule (a part of the inner ear).

Treatment Methods for Meniere's Disease?

Since there is no known cure for Meniere's disease, treatment focuses on managing symptoms. Following are some typical treatment options:

1. Dietary and Lifestyle Changes:

  • Reduce salt intake: Dietary sodium can cause fluid retention, so a low-sodium diet is recommended for those with Meniere’s.
  • Limit caffeine and alcohol: These can exacerbate symptoms for some.
  • Manage stress: Stress can trigger or worsen symptoms. Techniques for managing stress, such as relaxation exercises [like biofeedback], meditation, or yoga, are sometimes helpful.

2. Medications:

  • Diuretics: These “water pills” may help reduce the volume and pressure of fluid in the inner ear.
  • Antivertigo medications: These include meclizine, diazepam, etc.; they can help control vertigo symptoms.
  • Anti-nausea medications: During acute vertigo episodes, nausea and vomiting can be severe. Medications prescribed by a physician can help relieve these symptoms.

3. Injections:

  • Steroid injections: Medicines such as steroids can be injected into the middle ear to help control vertigo episodes in some people.
  • Gentamicin injections: Gentamicin is an antibiotic that is a useful medicine for treating severe cases of Meniere's disease. It appears to be effective for the treatment of vertigo and is usually very reliable; however, it may involve the risk of further hearing loss in some cases.

4. Surgical procedures: Reserved for cases in which symptoms are not adequately controlled by other treatments.

  • Endolymphatic sac decompression: An alternative surgery to treat vertigo episodes involves removing a bone in the inner ear to decrease fluid production or increase fluid absorption.
  • Vestibular nerve section: Cutting the vestibular nerve, which transmits balance signals to the brain, is a procedure that controls vertigo while attempting to preserve hearing in the affected ear.
  • Labyrinthectomy: When vertigo is severe and relief cannot be obtained through other methods, surgical removal of the entire inner ear may be recommended. This surgery does cause complete hearing loss in the treated ear, but this is often a matter of little or no consequence if the hearing ability in that ear is already largely damaged or gone.

5. Hearing aids: To manage hearing loss that is associated with Meniere's Disease.

6. Balance therapy: There are a few names for this therapy, Meniere's patients call it VRT, vestibular rehab therapy. It is not for everyone, especially those who haven't been stable for at least 6 months. It isn't comparable to what a Physical Therapist will go through, typically 4 or 5 sessions over a month.

Complications of Meniere's Disease

Meniere's disease can cause several complications, both from the disease itself and from the effect of its symptoms on the psyche. Here are a few of the main complications:

  • Progressive Hearing Loss: Repeated attacks of severe vertigo can cause a loss of hearing in the affected ear. Eventually, the hearing loss can become permanent.
  • Persistent Tinnitus: In some cases tinnitus is constant. The noise can be an irritating roaring, clicking, or hissing instead of ringing.
  • Vertigo Episodes: There is an increased risk of a fall from the vertigo attack especially if it happens when you are moving and standing up suddenly. The continuing and disabling problems with vertigo can cause chronic fatigue.
  • Chronic Fatigue: As may be anticipated, there has been no known cure for Meniere’s disease. With the severe unpredictability of the attacks and the devastating nature of the severe vertigo attacks, as well as other symptoms of the disease, many sufferers could understandably be fatigued, and our homeopathic treatment for Meniere’s aims to address this aspect.
  • Emotional Impact: The symptoms of Meniere's Disease disrupt daily life and are often unpredictable. This disruption can lead to emotional distress, such as:
  1. Anxiety: Worrying about when the next bout of vertigo will occur can cause significant anxiety.
  2. Depression: Dealing with chronic symptoms and their complications, such as altered work and personal life can lead to feelings of sadness hopelessness, or frustration.
  3. Social isolation: Many people with Ménière's often find they are very hesitant to fully engage in social or public activities.
  • Balance Problems: Even between vertigo attacks, some people may have problems with balance, increasing the risk of accidents.

Prevention of Meniere's Disease

It is difficult to prevent the development of Meniere's Disease in those who have never had it since the actual origin of the condition is not entirely understood. However, there are certain methods to help avoid or lessen the frequency and severity of episodes for persons with Meniere's Disease or for those at risk:

1. Dietary Changes:

  • Limit salt intake: A low salt diet may help decrease the build-up of fluid in the inner ear.
  • Avoid caffeine and alcohol: Some people find that these can either trigger or make existing symptoms worse.
  • Monitor fluid intake: Making sure to stay properly hydrated can help maintain a balanced amount of inner ear fluids.

2. Avoid Triggers: Some people with Meniere's may notice specific triggers for their episodes, such as certain foods, stress, or the lack of sleep. Identifying and avoiding these triggers is one good way to lessen the number of Meniere’s disease episodes.

3. Manage Stress: Stress is a potential trigger of Meniere's attacks. Activities that can help keep stress under control and bust tension like deep breathing, meditation, yoga, and regular exercise may be useful in reducing stress.

4. Quit Smoking: Smoking can make symptoms of Meniere's Disease worse.

5. Get Regular Sleep: Maintaining a regular sleep schedule and getting enough sleep may help to reduce the frequency of Meniere's disease attacks.

6. Avoiding sudden movements: For some people, quick head movements or positional changes can trigger vertigo. Being slow and cautious about such movements can be helpful.
7. Protecting your hearing: Continuous exposure to loud sounds can cause further hearing loss in persons with Meniere's Disease. It is important to use ear protection when in noisy environments.

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Frequently Asked Questions

Medfin offers the latest surgical procedures to ensure that you recover as fast as possible in the least painful way possible.

While it typically starts in one ear, over time, about 30-50% of people with Meniere's Disease can experience symptoms in both ears.

Activities that involve rapid head movements or changes in position might trigger vertigo in some individuals with Meniere's. However, regular, moderate exercise can be beneficial for overall well-being.

Changes in atmospheric pressure, such as during an airplane flight, can sometimes trigger symptoms in people with Meniere's Disease. It's advisable to discuss travel plans with a healthcare provider.

There is some evidence suggesting a genetic predisposition, as Meniere's Disease can run in families. However, many cases have no known family link.

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