Overview

Meniere's disease is a disorder of the inner ear that causes episodes in which you feel as if you're spinning (vertigo), and you have fluctuating hearing loss with a progressive, ultimately permanent loss of hearing, ringing in the ear (tinnitus), and sometimes a feeling of fullness or pressure in your ear. In most cases, Meniere's disease affects only one ear.

Meniere's disease can occur at any age, but it usually starts between the ages of 20 and 50. It's considered a chronic condition, but various treatments can help relieve symptoms and minimize the long-term impact on your life.

Source: http://www.mayoclinic.com

Symptoms

Signs and symptoms of Meniere's disease include:

• Recurring episodes of vertigo. You have a spinning sensation that starts and stops spontaneously. Episodes of vertigo occur without warning and usually last 20 minutes to several hours, but not more than 24 hours. Severe vertigo can cause nausea and vomiting.
• Hearing loss. Hearing loss in Meniere's disease may come and go, particularly early on. Eventually, most people have some permanent hearing loss.
• Ringing in the ear (tinnitus). Tinnitus is the perception of a ringing, buzzing, roaring, whistling or hissing sound in your ear.
• Feeling of fullness in the ear. People with Meniere's disease often feel pressure in the affected ears (aural fullness) or on the side of their heads.

After an episode, signs and symptoms improve and might disappear entirely. Episodes can occur weeks to years apart.

When to see a doctor

See your doctor if you have signs or symptoms of Meniere's disease. Because any one of them can result from other illnesses, it's important to get an accurate diagnosis as soon as possible.

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Causes

The cause of Meniere's disease isn't understood. One popular theory that hasn't been proved is that Meniere's disease appears to be the result of the abnormal amount of fluid (endolymph) in the inner ear. This often shows on autopsies, but it's not clear that it causes the episodes.

Factors that affect the fluid, which might contribute to Meniere's disease, include:

• Improper fluid drainage, perhaps because of a blockage or anatomic abnormality
• Abnormal immune response
• Allergies
• Viral infection
• Genetic predisposition
• Head trauma
• Migraines

Because no single cause has been identified, it's likely that Meniere's disease results from a combination of factors.

Source: http://www.mayoclinic.com

Diagnosis

Your doctor will conduct an exam and take a medical history. A diagnosis of Meniere's disease requires:

• Two episodes of vertigo, each lasting 20 minutes or longer but not longer than 24 hours
• Hearing loss verified by a hearing test
• Tinnitus or a feeling of fullness in your ear
• Exclusion of other known causes of these problems

Hearing assessment

A hearing test (audiometry) assesses how well you detect sounds at different pitches and volumes and how well you distinguish between similar-sounding words. People with Meniere's disease typically have problems hearing low frequencies or combined high and low frequencies with normal hearing in the mid frequencies.

Balance assessment

Between episodes of vertigo, the sense of balance returns to normal for most people with Meniere's disease. But you might have some ongoing balance problems.

Tests that assess function of the inner ear include:

• Videonystagmography (VNG). This test evaluates balance function by assessing eye movement. Balance-related sensors in the inner ear are linked to muscles that control eye movement. This connection enables you to move your head while keeping your eyes focused on a point.

  In a VNG evaluation, warm and cool water or warm and cool air are introduced into the ear canal. Measurements of involuntary eye movements in response to this stimulation are performed using a special pair of video goggles.

• Rotary-chair testing. Like a VNG, this measures inner ear function based on eye movement. You sit in a computer-controlled rotating chair, which stimulates your inner ear.
• Vestibular evoked myogenic potentials (VEMP) testing. This newer test shows promise for not only diagnosing, but also monitoring Meniere's disease. It shows characteristic changes in the affected ears of people with Meniere's disease.
• Posturography. This computerized test reveals which part of the balance system — vision, inner ear function, or sensations from the skin, muscles, tendons and joints — you rely on the most and which parts may cause problems. While wearing a safety harness, you stand in bare feet on a platform and keep your balance under various conditions.
• Video head impulse test (vHIT). This newer test uses video to measure eye reactions to abrupt movement. While you focus on a point, your head is turned quickly and unpredictably. If your eyes move off the target when your head is turned, you have an abnormal reflex.
• Electrocochleography (ECoG). This test looks at the inner ear in response to sounds. It might help to determine if there is an abnormal buildup of fluid in the inner ear, but isn't specific for Meniere's disease.

Tests to rule out other conditions

Blood tests and others may be used to rule out disorders that can cause problems similar to those of Meniere's disease, such as a tumor in the brain or multiple sclerosis. An imaging test, such as an MRI, also might be used.

Source: http://www.mayoclinic.com

Complications

The unpredictable episodes of vertigo and the prospect of permanent hearing loss can be the most difficult problems of Meniere's disease. The disease can interrupt your life and cause fatigue, emotional stress, depression and anxiety.

Vertigo can cause you to lose balance, increasing your risk of falls and accidents while driving or operating heavy machinery.

Lifestyle and home remedies

Certain self-care tactics can help reduce the impact of Meniere's disease. Consider these tips for use during an episode:

• Sit or lie down when you feel dizzy. During an episode of vertigo, avoid things that can make your signs and symptoms worse, such as sudden movement, bright lights, watching television or reading.
• Rest during and after attacks. Don't rush to return to your normal activities.
• Be aware you might lose your balance. Falling could lead to serious injury. Use good lighting if you get up in the night. Consider walking with a cane for stability if you have chronic balance problems.
• Avoid driving a car or operating heavy machinery if you have frequent episodes of vertigo. Doing so could lead to an accident and injury.

Lifestyle changes

Salt and stress can affect hearing and balance. To avoid triggering a vertigo attack, try the following.

• Limit salt. Consuming foods and beverages high in salt can increase fluid retention. Aim for 1,500 to 2,000 milligrams of sodium each day and spread your salt intake evenly throughout the day.
• Manage stress. Managing stress might lessen the severity of symptoms and help you cope with Meniere's disease. Psychotherapy can help you identify stressors and develop strategies for coping with your condition.

Source: http://www.mayoclinic.com

Coping and support

Meniere's disease can affect your social life, your productivity and the overall quality of your life. Learn all you can about your condition. Talk to people who share the condition, possibly in a support group. Group members can provide information, resources, support and coping strategies. Ask your doctor or therapist about groups in your area or look for information from the Vestibular Disorders Association.

Source: http://www.mayoclinic.com