What is Ménière’s Disease?
Ménière’s disease is a disorder of the inner ear, characterized by symptoms that often come in episodes of vertigo, nausea, vomiting, loss of hearing, ringing in the ears, fullness in the ears, headaches, loss of balance, and sweating. It is believed that symptoms occur due to a build up of fluid in the labyrinth of the ear. Usually one ear is affected, but on rare occasions both can be affected. The cause of Ménière’s disease is unclear, but likely involves both genetic and environmental factors. The disease can start at any age and affect both men and women equally.
What are the Symptoms of Ménière’s Disease?
Symptoms of Ménière’s disease may include, but are not limited to the following:
- Recurring episodes of vertigo: A spinning sensation that starts and stops spontaneously. Episodes of vertigo occur without warning lasting 20 minutes to several hours, but not more than 24 hours. Severe vertigo can cause nausea.
- Hearing loss: At first hearing loss can come and go, specifically when having an episode of vertigo, but eventually some permanent hearing loss is experienced.
- Tinnitus: Tinnitus is ringing, buzzing, roaring, whistling, or hissing sound in your ear. Tinnitus can be consistent or come and go.
- Feeling of fullness in the ear: People with Ménière’s disease often feel pressure in the affected ear.
- Nystagmus: Rapid, sudden, and uncontrollable eye movements occur with Ménière’s disease because the same part of the inner ear essential for balance also controls eye movement.
Often people will start with just one symptom, but eventually over time all or most symptoms will start to appear. Episodes and symptoms can come and go, and it can seem things improve and might disappear entirely for a while. Over time, the frequency of episodes may lessen. The unpredictable episodes of vertigo and the prospect of permanent hearing loss can be the most difficult problems of Ménière’s Disease. The disease can unexpectedly interrupt your life, causing fatigue and stress and symptoms can become more severe as the disease slowly progresses.
What are the Stages of Ménière’s Disease?
Ménière’s disease develops in two stages. Between these stages, a person might not experience symptoms for extended periods (even years).
Early Stage of Ménière’s Disease
The early stage of Ménière’s disease causes sudden and unpredictable episodes of vertigo. During these episodes, there will be some loss of hearing, which typically returns to normal once the vertigo subsides. After a vertigo attack there is often extreme exhaustion and the need to sleep for multiple hours. The ear may feel uncomfortable and blocked with a sense of fullness or pressure. Tinnitus is also common in this stage.
People may also experience the following during the early stages of the disease:
- Blurry vision
- Cold sweat
- Palpitations or a rapid pulse
Late Stage of Ménière’s Disease
As the disease progresses, vertigo episodes become less frequent and, in some cases, never come back. However balance, hearing, and vision problems can continue, and usually get steadily worse. It is also common to experience drop attacks, which involve spontaneously losing posture or suddenly falling down while remaining conscious. These attacks can lead to serious injuries and often the person is unable to drive or work.
What are Triggers of Ménière’s Disease?
Since Ménière’s disease symptoms can wax and wane, some sufferers report certain triggers for their symptoms including, but not limited to, the following:
- Diet - particularly salt, sugar and alcohol, MSG and caffeine
- Stress and anxiety
- Loud sounds
- Visual environments - bright lights or disoriented movement
- Environmental triggers such as chemicals and fragrances
- Food allergies
- Hay fever
What Causes Ménière’s Disease?
It is understood that Ménière’s disease is caused by a build up of fluid behind the ears, but the exact cause of this build up is not truly known. Many agree that the following can trigger the onset of the illness, and because no single cause has been identified it's likely that Ménière’s disease results from a combination of factors:
- Improper fluid drainage - perhaps because of a blockage or anatomic abnormality
- Autoimmune disease
- Viral infection (such as herpes simplex)
- Genetic predisposition
- TMJ disorders
What Testing is There for Ménière’s Disease?
A diagnosis of Ménière’s disease requires:
- Two episodes of vertigo, each lasting 20 minutes or longer but not longer than 12 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
- Other testing can include:
- Videonystagmography (VNG)
- Rotary-chair testing
- Vestibular evoked myogenic potentials (VEMP) testing
- Video head impulse test (vHIT)
- Electrocochleography (ECoG)
Blood tests and imaging scans such as an MRI may be used to rule out disorders that can cause problems similar to those of Ménière’s disease, such as a tumor in the brain or multiple sclerosis. It is important to note that the fluid build up is not seen on an MRI but suffers often report that MRIs can trigger vertigo.
What is the Treatment for Ménière’s Disease?
Conventional treatment uses medications for vertigo, nausea and diuretics, physiotherapy, injections and surgery. Often patients are recommended to follow a low sodium diet to keep the fluid build up at a minimum. Many people find this helpful, but their lives are still controlled by unpredictable vertigo attacks. At Ananta Health, a thorough assessment of the patient's history is taken and BioScan SRT testing is performed. This will help determine lifestyle recommendations, diet changes, and supplements and herbs that can help control the symptoms of the illness.
Acupuncture is also an important factor in treating Ménière’s disease as it can have a great effect on vertigo, nausea and fatigue often associated with the illness.