Meniere's disease: understanding the condition and its treatment
As an Audiologist, I often come across patients who are struggling with a condition called Meniere's disease. This condition affects the inner ear and can cause symptoms such as dizziness, vertigo, tinnitus (ringing in the ears), and hearing loss. While Meniere's disease can be a challenging condition to live with, with proper diagnosis and treatment, patients can manage their symptoms and lead a full, active life. In this article, we will take a closer look at Meniere's disease, including its causes, symptoms, and treatment options.
What is Meniere's Disease?
Meniere's disease is a chronic inner ear condition that affects the balance and hearing mechanisms within the ear. It was first described by French physician Prosper Meniere in 1861, and since then, has become a well-known and recognised condition within the medical community. While the exact cause of Meniere's disease is not fully understood, it is believed to be the result of a buildup of fluid within the inner ear. This fluid can cause changes in pressure within the ear, leading to the symptoms associated with the condition.
The symptoms of Meniere's disease can vary greatly from person to person, but typically include:
Dizziness or vertigo: This is a feeling of spinning or unsteadiness, often accompanied by nausea and vomiting. Vertigo can last anywhere from a few minutes to several hours.
Tinnitus: This is a ringing, buzzing, or whistling sound in the ears that is not caused by an external source.
Hearing loss: This can be sudden or gradual, and may fluctuate or become permanent over time.
Fullness or pressure in the ear: This is a feeling of fullness or pressure within the ear that is often accompanied by the other symptoms of Meniere's disease.
While Meniere's disease can affect anyone, it is most commonly diagnosed in individuals between the ages of 40 and 60. Other risk factors include:
Family history: There may be a genetic component to the development of Meniere's disease, as it has been known to run in families.
Stress: High levels of stress have been linked to an increased risk of developing Meniere's disease.
Other health conditions: Some health conditions, such as migraines, high blood pressure, and diabetes, have been linked to an increased risk of Meniere's disease.
Diagnosing the disease
Diagnosing Meniere's disease can be a challenge, as its symptoms can be similar to those of other conditions such as migraines or inner ear infections. A definitive diagnosis of Meniere's disease can only be made by an Audiologist or an ear, nose and throat specialist (ENT). During a diagnostic assessment, the Audiologist will ask about your symptoms and medical history, and will perform a physical examination of your ears, neck and eyes to rule out any other causes of your symptoms.
In addition, the audiologist may also perform a hearing test to assess the degree and type of hearing loss you are experiencing, and a balance test to assess your vestibular system. A referral to ENT may be required to order further tests such as an MRI or a CT scan, to rule out other conditions that may be causing your symptoms.
To make a diagnosis, an Audiologist will typically perform a comprehensive evaluation that includes:
Hearing test: An Audiologist will perform a hearing test to assess any changes in hearing that may be associated with Meniere's disease.
Vestibular testing: This is a series of tests designed to assess the functioning of the inner ear and the balance mechanisms within it.
Medical history: An Audiologist will take a thorough medical history to determine if there are any underlying health conditions that may be contributing to the development of Meniere's disease.
Based on the results of these tests, an Audiologist can make a diagnosis of Meniere's disease and work with the patient to develop a treatment plan.
There is currently no cure for Meniere's disease, but there are various treatments available to help manage the symptoms. The goal of treatment is to reduce the frequency and severity of vertigo episodes, prevent hearing loss and improve quality of life.
The most common treatments for Meniere's disease include:
Diet and lifestyle changes: Reducing salt and caffeine intake, and avoiding triggers such as stress and alcohol, can help manage symptoms.
Medications: Anti-vertigo drugs, such as meclizine and diazepam, can help relieve vertigo symptoms.
Vestibular rehabilitation: This is a type of physical therapy that helps improve balance and reduce the frequency of vertigo episodes.
Surgery: In severe cases of Meniere's disease, surgery may be recommended to remove the affected part of the inner ear or to insert a shunt to drain excess fluid.
A diagnostic assessment is important because it can help to accurately diagnose Meniere's disease, rule out other causes of your symptoms and determine the most appropriate treatment plan for you.
Related reading
References
Gates, G. A. (2006). Meniere's disease review 2005. Journal of the American Academy of Audiology, 17(01), 016-026.
Harcourt, J., Barraclough, K., & Bronstein, A. M. (2014). Meniere’s disease. Bmj, 349.
Nakashima, T., Pyykkö, I., Arroll, M. A., Casselbrant, M. L., Foster, C. A., Manzoor, N. F., ... & Young, Y. H. (2016). Meniere's disease. Nature reviews Disease primers, 2(1), 1-18.
