The Definition of Meniere's Disease

Ménière's disease is a syndrome of symptoms which impact the patient's life (work, home, leisure). The causes are not fully understood, but she can get a diagnosis from an ear, nose and throat specialist, and medications can help her control the worst of her symptoms.

Ménière's Disease Defined

• This is a disorder of the inner ear; the patient will experience abnormal sensations such as vertigo (a dizzy, spinning sensation), pressure in one ear, a loss of hearing in that same ear and tinnitus (ringing noise) in the same ear. According to the National Institute on Deafness and Other Communication Disorders, approximately 615,000 people suffer from this disease; sufferers are typically in their 40s and 50s.

Causes

• Causes of Ménière's disease are not very well understood; the condition seems to originate from the volume of fluid in the inner ear. What triggers the change in this inner ear fluid is not known. This fluid (endolymph) resides inside the membranous labyrinth of the ear. Tiny hairs line this cavity; these hairs respond to the movement of the endolymph and send impulses to the brain. There may be factors which cause an alteration of the endolymph fluid which contribute to Ménière's disease.

Symptoms

• The patient may experience vertigo which seems to come and go; these episodes can last for as little as 20 minutes to as long as two hours and can cause nausea and vomiting. The patient can experience hearing loss in one ear. This loss can fluctuate, sometimes being more acute and sometimes more mild. In Ménière's disease, some degree of hearing loss will eventually be permanent. Aural fullness is another symptom; this is the feeling of pressure or fullness in the ear, and it will happen in the same ear which has the hearing loss. The patient may also develop tinnitus, which is the perception of sound in the ear: ringing, hissing, buzzing, whistling or roaring. Again, tinnitus will be experienced in the same ear that has the hearing loss and sensation of fullness.

Treatments

• There is no cure for Ménière's disease; all the patient can hope to do is to manage her symptoms. Her doctor can prescribe medications to reduce the incidence and severity of vertigo, nausea and/or vomiting. These medications are meclizine or diazepam to reduce the sensation of spinning and control the nausea; prochlorperazine can be prescribed to control the nausea and physical illness. In the long term, her doctor may prescribe a diuretic to control fluid retention; these are triamterine and hydrochlorothiazide. These medications may help control the frequency and/or severity of Ménière's disease symptoms.

Complications

• Vertigo is usually the most disabling symptoms the patient experiences. If he experiences a sudden, unexpected episode of vertigo, he can fall. His vertigo can force him to give up a full life and make it necessary for him to lie down until the worst of the dizziness has gone away. He will have to stop driving and/or operating heavy machinery since his symptoms are unpredictable; the episodes of vertigo can pose a danger to him as well as to others he encounters. Because he cannot control his symptoms and they can have such a huge impact on his life, he can develop symptoms of depression.