Meniere disease

Meniere’s disease is a vestibular disorder that produces a recurring set of symptoms as a result of abnormally large amounts of a fluid called endolymph collecting in the inner ear.

The prevalence of Meniere’s disease is difficult to assess. One population study found that 15.3 per 100,000 individuals develop Meniere’s disease annually. Of these, one-third eventually develop the disease in the second ear as well.

The exact cause of Meniere’s disease is not known. Theories include circulation problems, viral infection, allergies, an autoimmune reaction and the possibility of a genetic connection. Experts also aren’t sure what generates the symptoms of an acute attack. Some people with Meniere’s disease find that certain triggers can set off attacks, including stress, overwork, fatigue, emotional distress, additional illnesses, pressure changes, certain foods, and too much salt in the diet.

Attacks can last from 20 minutes to 24 hours. They can occur many times per week; or they can be separated by weeks, months, and even years. The unpredictable nature of this disease makes it difficult to tell how it will affect a person’s future. Symptoms can disappear one day and never return, or they might become so severe that they are disabling.

Symptoms: During an attack of early-stage Meniere’s disease, the main symptoms are spontaneous, violent vertigo fluctuating hearing loss, ear fullness, and/or tinnitus. Following the attack, a period of extreme fatigue or exhaustion often occurs, prompting the need for hours of sleep. The periods between attacks are symptom-free for some people and symptomatic for others.
Treatment: In the United States, the most conservative long-term treatment for Meniere’s disease (aimed at reducing the severity and number of attacks) involves adhering to a reduced-sodium diet and using diuretics, or “water pills.” The goal of this treatment is to reduce inner ear fluid pressure.

Medications that are used during an attack to reduce the vertigo, nausea, and vomiting include diazepam (Valium), promethazine (Phenergan), dimenhydrinate (Dramamine Original Formula), and meclizine hydrochloride (Antivert, or Dramamine Less Drowsy Formula). Vestibular rehab therapy is sometimes used to help with the imbalance that can plague people between attacks. Its goal is to help retrain the ability of the body and brain to process balance information.