Ménière's disease

A disorder of the inner ear

What is Ménière's disease?

A disorder of the inner ear, Ménière's disease is a progressive condition that can develop at any age. It affects balance and hearing, causing vertigo, dizziness and hearing loss. In most cases, people with Ménière's disease experience symptoms in one ear and often experience a gradual decline in hearing in the same ear.

Ménière's disease is characterised by bouts of vertigo, which can be very severe and last for anywhere from two to four hours at a time. While the attacks will usually subside after a few hours, it may take several days for the symptoms to completely disappear. For some, these vertigo attacks can be very frequent, with several occurring in a short time, while for others, months and even years may go by between episodes. These attacks can come on suddenly or may be preceded by warning signs such as earache, a ringing, roaring or hissing sound in the ear (tinnitus), abnormal hearing or a feeling of pressure in the ear

Who is affected?

Ménière's disease is not a common condition; however, it can develop at any age and affects both genders equally. The condition tends to fluctuate, with phases of acute symptoms followed by phases of remission. Certain sufferers may experience further complications, for example, those with professions that rely on a sense of balance, such as scaffolders, pilots, and bus drivers.

While it is difficult to predict who will develop Ménière's disease, a person may be at higher risk if they have a family member with the condition, have an autoimmune disease such as diabetes, lupus or rheumatoid arthritis, or have allergies. Prior head injuries, particularly ones involving the ear, and previous viral infections of the inner ear may also put a person at higher risk of Ménière's disease.

How common is Ménière's disease?

Ménière's disease is not a very common condition, estimated to affect up to 750 people per 100,000. While it can affect people of any age, Ménière's disease most commonly affects people in their 40s and 50s and is rarely seen in children.

Causes of Ménière's disease

At the present time, the cause of Ménière's disease is unknown. However, the symptoms of the condition are caused by a build-up of fluid within the inner ear, which impacts balance and hearing.

Symptoms of Ménière's disease

Ménière's disease symptoms are often experienced in attacks that start suddenly and last for several hours at a time. People with the condition may experience attacks frequently or more sporadically, with days, weeks or months between each attack.

Some common Ménière's disease symptoms include vertigo, noise sensitivity, trouble hearing clearly, tinnitus, pressure within the ear and hearing loss.

The progression of the condition is identified by three stages: early, middle and late stages. Early stage Ménière's disease is characterised by sudden, unpredictable attacks, while later stages see the frequency of attacks lessen over time. However, the way that Ménière's disease progresses does vary from person to person.

What are the three stages of Ménière's disease?

It’s important to note that as Ménière's disease progresses, the degree of hearing loss experienced does often increase. Tinnitus also commonly accompanies the increase in hearing loss.

Ménière's disease can be divided into three stages: early, intermediate and late. Symptoms may vary between people and over time.  What are the three stages of Ménière's disease? Let’s take a closer look.

Early Stage

The earliest stage of Ménière's disease includes unpredictable vertigo attacks, which can last from a few minutes to hours. During the attack, there may be a variable amount of hearing loss and a feeling of fullness in the ear. Some people may also experience tinnitus in the affected ear during this stage of the disease, which  may precede a bout of vertigo. However, the attacks can often come without warning. Vertigo may also cause nausea, vomiting and dizziness.

Middle Stage

The attacks continue in the intermediate stage; however, they may now be less severe. A period of movement-induced dizziness or loss of balance may occur before or after the attack, and there may be symptoms of tinnitus along with the development of hearing loss and continued vertigo. 

Late Stage

In the late stage of Ménière's disease, hearing loss symptoms increase, and the symptoms of vertigo often reduce or stop completely. Hearing loss may be severe at this stage, and distortion and discomfort with loud sounds may occur. At stage 3 of the condition, balance problems are common (particularly in the dark) due to the permanent damage done to the balance organ in the ear.

How do you test for Ménière's disease?

There is no specific test for Ménière's disease, but if you are experiencing vertigo with hearing loss, tinnitus and a feeling of fullness or pressure in the ear, an Ear, Nose, and Throat specialist may use a range of tests to confirm a diagnosis of this disorder. The ENT will likely perform hearing tests to check if hearing loss is specific to the inner ear. Low-frequency hearing loss is often an indicator of Ménière's disease. They may also perform an electronystagmography to measure involuntary eye movement while your balance is tested and may recommend an MRI to rule out central nervous system disorders that have similar symptoms to Ménière's disease.

A woman wearing her earrings next to her hearing aid

Hearing aids for Ménière's disease

Hearing aids may help with mild to moderate hearing loss caused by Ménière's disease. Get in touch with your Bay Audiology clinician to find out what options may be available for your level of hearing loss.

Ménière's disease treatment

If you are experiencing vertigo, book an appointment with your GP. Depending on their assessment of your symptoms, you may be referred to an ear, nose and throat specialist or prescribed medication to help alleviate the severity of your symptoms.

People who receive this diagnosis often ask, how long does Meniere's disease last? Ménière's disease is an ongoing condition that unfortunately can’t be cured. However, some people with the condition experience periods of remission where the symptoms are very mild or non-existent.

Because there is no cure, Ménière's disease treatment focuses on managing symptoms and preventing (or reducing the severity of) attacks. To help reduce the frequency of the attacks and their severity, those with the condition may:

  • Learn to recognise the warning signs that an attack is starting.
  • Take time to rest after an attack.
  • Become acquainted with the triggers that exacerbate symptoms.
  • Avoid alcohol, caffeine and smoking.
  • Reduce their daily sodium intake.
  • Take part in vestibular rehabilitation therapy.
  • Take medications that control nausea, vertigo and fluid retention within the ear.

If your vertigo doesn’t respond to medical intervention, your doctor may also suggest pressure pulse devices, which can help relieve pressure build-up within the ear and thus reduce vertigo. Chemical ablation is another non-surgical option for treatment-resistant vertigo. In this procedure, doctors use an antibiotic to reduce or destroy the ear’s vestibular functions (responsible for balance). In doing so, signals are no longer sent to the brain.

In some severe cases, surgery may be required to reduce the amount of fluid within the inner ear or to cut the nerve that sends balance and movement signals to the brain. Although surgery will not cure the condition, it may help to reduce the severity of symptoms such as vertigo.

If attacks are triggered by stress, it is worth speaking to your healthcare practitioner about mental health support. And if you are experiencing hearing loss as a result of Ménière's disease, hearing aids (many of which are designed to also alleviate tinnitus) can be an option.

Ménière's disease can be difficult to live with, especially if you are experiencing its early stages. Consider connecting with a support group if you have questions about living with symptoms, dealing with attacks or monitoring the condition’s progression.

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