Meniere’s Disease: What is it, Causes, Symptoms and Treatment

Meniere’s disease is a disorder characterized by vertigo (dizziness), tinnitus (ringing in the ears) and progressive deafness.

Meniere’s disease is a disorder characterized by vertigo (dizziness), tinnitus (ringing in the ears) and progressive deafness. Although there is no definitive treatment for this disorder yet, it is possible to control the complaints with various treatments.

What is Meniere’s Disease?

Meniere’s disease is a serious disorder that affects the inner ear. In the human body, the inner ear contains structures responsible for hearing and balance functions. When this situation occurs, vertigo occurs, which is felt as dizziness. During the course of the disorder, problems such as hearing problems and tinnitus may also occur, depending on the level of involvement of the inner ear. Meniere’s disease usually tends to affect individuals in one ear.

What are the causes of Meniere’s Disease?

The incidence of Meniere’s disease varies between 3 and 500 per 100,000. The group in which this disorder is most commonly detected is elderly and white-skinned female patients. The real reason for the emergence of Meniere’s disease has not been clearly revealed yet. There are various theories on this subject, and the effect of genetic and environmental factors is especially emphasized.

Abnormal levels of the fluid called endolymph in the inner ear are effective in the symptoms of Meniere’s disease. The factors that play a role in affecting this fluid level can be summarized as follows:

• Impairment of fluid drainage due to anatomical abnormality or obstruction in the channels,
• Abnormal response of the immune system to various situations,
• viral infections,
• Having genetic factors that increase susceptibility to Meniere’s disease.

It is thought that there is not a single factor in the development of Meniere’s disease, but that it may occur due to combinations of various factors.

What are the symptoms of Meniere’s Disease?

Symptoms that occur with Meniere’s disease vary from person to person. Complaints that occur at the same time usually occur suddenly. There may also be various differences in the frequency and duration of complaints. The medical world considers the sudden onset of symptoms as an attack of the disease. Classically, there are attacks with a feeling of fullness in the ear, fluctuating hearing loss and dizziness, and the duration of these attacks can vary from 20 minutes to 24 hours from patient to patient. The main symptoms that may occur during attacks are as follows:

dizziness

The complaint of severe dizziness, referred to as vertigo, is among the most prominent symptoms of Meniere’s disease. Complaints that may occur with the formation of vertigo can be summarized as follows:

• Even if the person is standing still, he/she continues to perceive that his/her surroundings are rotating,
• Nausea, vomiting.

It is very difficult to predict when a vertigo attack will occur in Meniere’s patients. For this reason, it is very important for people suffering from this disorder to always have their vertigo-related medications nearby. Care should be taken as the symptoms of a vertigo attack may also occur during activities such as driving, using heavy machinery, climbing activities such as climbing stairs, or swimming.

tinnitus

Annoying tinnitus, which tends to persist, is another symptom that occurs in Meniere’s patients. This complaint may occur in the form of ringing, whistling, whispering or humming. Meniere’s patients complain of tinnitus more, especially when they are tired or in a quiet environment.

Hearing loss

The level of hearing loss is a symptom that fluctuates according to the course of the disease. Meniere’s patients may also be more sensitive to loud sounds. Care should be taken as the majority of individuals with this disease will experience varying degrees of hearing loss over time.

Psychiatric Symptoms Such as Anxiety, Stress and Depression

Psychiatric symptoms are among other complaints that may occur during the course of Meniere’s disease. The occurrence of these symptoms cannot be predicted and may also negatively affect the individual’s ability to work. In particular, as hearing loss gradually worsens over time, it can disrupt individuals’ social interactions and pave the way for psychological complaints.

Over time, individuals with Meniere’s disease may encounter restrictions on freedom, difficulties in business life, and various problems in their relationships with their immediate environment. If these situations occur, it is a natural consequence that psychological problems such as anxiety and depression occur in individuals. Therefore, it is very important for individuals with Meniere’s disease to be aware of their mental distress and receive support from specialist physicians.

Meniere’s disease is basically examined in two stages. Between these two stages, people may not have long-term complaints. In the early stages of the disease, people experience sudden onset and unpredictable vertigo attacks. Although people may experience mild hearing loss during these attacks, this symptom returns to normal as the vertigo attack subsides. Individuals may feel uncomfortable symptoms such as fullness and pressure in their ears during an attack. Ringing in the ears, also referred to as tinnitus, is another common symptom that occurs in the early stages. Once the vertigo attack ends, patients may feel very tired and exhausted. Individuals often feel an intense need for sleep due to this feeling of exhaustion.

In the late stages of Meniere’s disease, the frequency of vertigo attacks gradually decreases and in some patients the attacks may end. However, it should not be forgotten that problems with balance, hearing and vision will continue. Individuals complain that complaints intensify, especially in dark environments. Complaints such as hearing loss and tinnitus tend to worsen in the late stages of the disease. In some individuals, as the disease progresses, loss of balance becomes very bad and may cause the person to fall, so care should be taken.

How is Meniere’s Disease Diagnosed?

After applying to health institutions with complaints of Meniere’s disease, physicians first apply for a physical examination and medical history taking. The methods used to diagnose the disorder can be summarized as follows:

• 2 different vertigo attacks lasting at least 20 minutes but not exceeding 12 hours, recorded by an ENT specialist,
• 3 attacks, at least one of which has been evaluated and described by the patient
• Caloric tests
• Electrocochleographs
• Exclusion of other disorders that may cause existing complaints.

Audiometric tests are very important in the diagnostic approach to Meniere’s disease. Audiometric examinations, also known as hearing tests, serve to reveal a person’s capacity to discriminate between various sound frequencies. Although people with Meniere’s disease generally have problems perceiving low-frequency sounds, some patients may have hearing problems at both low and high frequencies.

In addition to audiometric examinations, various balance tests can be used in the diagnosis of Meniere’s disease. Videonystagmography (VNG) is an important examination that evaluates body functions related to balance by examining eye movements. In addition to VNG examination, other examinations such as rotating chair test, vestibular evoked myogenic potential test, posturography, video head impulse test and electrocochleography may also be used.

How is Meniere’s Disease Treated?

Meniere’s disease is a chronic (long-term) disorder and it is not currently possible to fully treat it. While the complaints of patients can be controlled with various drug treatments, sometimes in severe extreme cases, various surgical treatments may also come to the fore.

Frequently Asked Questions About Meniere’s Disease

One of the most frequently asked questions about Meniere’s disease is which drugs are used for treatment. Medicines used to treat conditions such as motion sickness and seasickness may be beneficial in controlling complaints such as vertigo, nausea and vomiting caused by Meniere’s disease. If nausea and vomiting are severe, anti-nausea medications called antiemetics can be used. Diuretic drugs, known as diuretics, may be beneficial in preventing excessive accumulation of endolymph fluid, which plays an important role in the emergence of Meniere’s disease. In some cases, physicians may also resort to injection of medications into the ear to control their patients’ complaints. Another important issue that Meniere’s patients are curious about is the nutrition plan. Limiting foods and substances such as salt, chocolate and monosodium glutamate in the nutrition plan is an approach that can be effective in alleviating complaints.