Meniere's disease is a disorder of the inner ear which causes episodes of vertigo, ringing or roaring in the ears, a feeling of fullness or pressure in the ear, and fluctuating hearing loss. A typical attack of Meniere's disease is preceded by fullness in one ear. Hearing fluctuation or changes in tinnitus may also precede an attack. A Meniere's episode or attack generally involves severe vertigo, imbalance, nausea and vomiting as well as acute reduction of hearing. The average attack lasts two to four hours. Following a severe attack, most people find that they are exhausted and must sleep for several hours.
Causes
Although there is no exact cause of Meniere's, it most likely has something to do with increased pressure in the inner ear, which is full of a fluid known as endolymph. Another name for Meniere's is primary idiopathic endolymphatic hydrops, which essentially means abnormal fluid in the inner ear.
Potential causes or triggers of Meniere's disease include head injury, infection to the inner or middle ear, allergies, alcohol use, stress, side effects of certain medications, smoking, stress or anxiety, fatigue, family history of the disease, respiratory infection, recent viral illness, abnormal immune response and migraines
Symptoms
People with Meniere's can experience:
a feeling of pressure in the ear
sudden dizzy spells
tinnitus
muffled hearing or hearing loss
Symptoms vary from person to person, and some will experience many attacks over a period of several days, and others will have an isolated attack every once in awhile. To diagnose the disease, you must experience tinnitus, hearing loss and vertigo more than once. Since all of these issues can stand alone or be associated with other diseases, Meniere's can sometimes be difficult to diagnose. In some cases, people also experience diplacusis, known as double hearing.
Treatment
At the present time there is no cure for Meniere's disease, but there are ways to manage the condition and help control symptoms. Some recently refined treatments are (i.e. low dose gentamicin) generally allow people to avoid disability from dizziness due to Meniere's .
Medications
Medications commonly used for an acute attack include the following:
Meclizine, chewable. Dose ranges from 12.5 twice/day to 50 mg three times/day. This medication is over the counter. No prescription is necessary.
Lorazepam 0.5 mg. Usual dose is twice/day or both at the same time at onset. This medication is effective even if it is not swallowed (i.e. you can just suck on it). Tiredness is expected.
Promethazine, orally or rectal suppository (25 mg). Usual dose is once every 12 hours as needed for vomiting.
Prochlorperazine. Usual dose is 5-10 mg every 12 hours as needed for vomiting.
Ondansetron. Usual dose is 8mg q 12 hrs for vomiting. Although Ondansetron isn't as strong as phenergan or compazine, and doesn't always work, it also doesn't have much side effects either. One can certainly work and drive after taking nearly any dose of ondansetron. The same cannot always be said for meclizine, lorazepam and klonazepam, phenergan or compazine.
Dexamethasone 4 mg orally for 4-7 days. Or a medrol dose pack. This convenient, rapid, but not very effective treatment is gradually being replaced by steroid injections through the ear drum. It is usually an "add-on" at the time of a physicians visit for persistent symptoms.
Meniere's diet recommendations
Dietary changes may decrease the amount of fluid in the inner ear, which can weaken the symptoms of the disease. Researchers looking at this issue concluded there aren't any good clinical trials on diet and Meniere's disease. The good news? These changes are worth trying because they aren't harmful and may improve your overall health:
Decreasing sodium in your diet may help symptoms of Meniere's disease.
Reduce salt intake: Salt helps the body to retain water, so reduce intake of sodium-rich beverages and foods.
Drink less caffeine: Caffeinated beverages can make symptoms like tinnitus worse, so it is best to decrease the amount of this stimulant in your diet.
Along with the common symptoms of Meniere's disease, it's possible to suffer from depression or anxiety. Since the ailment affects hearing, you may lose the confidence to have conversations with others or at work, which can contribute to depression or anxiety. In addition, symptoms tend to pop up out of nowhere, so those living with Meniere's can be in a constant anxious state, unsure of when an episode will occur.
