Mending Meniere’s Disease

Watching and listening to the television can be a nightmare. Listening for the voices—you find them indistinct, you can’t make them out. Your ears are filled with pressure and roaring noises. You could have Meniere’s disease.

Meniere’s disease is a problem involving the inner ear. You experience episodes of vertigo (dizziness), tinnitus (ringing in the ears), a feeling of fullness or pressure in the ear and hearing loss. Meniere’s often presents as a sudden attack of dizziness, loss of balance and sometimes nausea and vomiting. A feeling of pressure in the ear may precede an attack. Such episodes may last several hours and leave the patient physically worn out. A particularly severe problem can be sudden falls that occur without warning and can result in serious injury.

Attacks in Meniere’s often occur in clusters over a short period of time. Years can go by between such clusters. The problem usually begins in one ear but often is slowly progressive and eventually involves both. Most people who will have bilateral involvement develop this within five years.

The cause of Meniere’s disease is poorly understood and may vary among patients. The symptoms are thought to derive from an increase in inner-ear fluid, called endolymph. The higher pressure from this excess fluid can produce abnormal signals that tell your brain you’re in motion even though you are stationary. The excess fluid can cause fluctuations in hearing as well.

Meniere’s sufferers typically have no warning of the disease. Many simply wake up one night to a room spinning wildly.

And what happens next depends on the person. For some, the spinning disappears for years. For others, the nausea and unsteadiness become a daily burden. Attacks of vertigo can last 20 minutes to several hours. Feelings of drowsiness and off balance can last for days afterward.

The disease typically starts between the ages of 20 and 50. It affects both sexes equally.

Although the attacks associated with Meniere’s disease can be frightening, disabling and even depressing, the condition itself is not life-threatening. Most patients do well between episodes, which usually occur only once in a while. Between attacks, patients may have residual hearing loss and tinnitus that worsen with time.

The inner ear is composed of two main portions, a hearing portion called the “cochlea,” and the balance portion, which are the semicircular canals. Each of these organs is a bony structure lined within a membrane that controls the amount of fluid or endolymph, contained within these two structures. This fluid-like substance transmits vibrations that enter the ear into sound as they are interpreted by one’s hearing abilities. This same fluid also moves within the semicircular balance canals and helps to determine one’s balance feelings as the body shifts from one position to another. The hearing and balance sensations are interpreted finally by specialized centers within the brain.

The endolymph fluid within the canals of the inner ear is maintained as relatively normal and constant levels in the healthy person. Those with Meniere’s disease have an imbalance of the amount of this fluid, as it becomes excessive, doesn’t flow normally within the canals and consequently builds up increased levels of pressure within the hearing and balance canals. This produces feelings of dizziness, increased pressures within the ears, hearing losses and tinnitus (ringing, whining or buzzing sounds). It is no wonder that people suffering from these symptoms are unable to function in even near-normal fashion during such attacks.

Further complicating our understanding of Meniere’s is the fact that not all people with Meniere’s are found to have this excess fluid.

When an attacks occurs, patients should lie down, stay still and avoid drinking or eating. Attacks lasting longer than a few hours or where nausea and vomiting are severe, should be treated by a doctor.

Medications used to treat an attack include sedatives, motion-sickness medications, anti-nausea medications and even steroids.

Medications also can be used to prevent or reduce the frequency of attacks. Patients with severe problems may be candidates for surgery to either cut some of the nerves involved or to try to reduce the fluid buildup.

Diet can also have an effect on Meniere’s. Foods high in sugar and salt can affect the quality and quantity of the fluid in the inner ear. Alcohol, caffeine, tobacco and foods containing monosodium glutamate (a flavor enhancer used in processed foods and commonly used in Chinese foods) may worsen symptoms and should be avoided. Aspirin and aspirinlike products such as ibuprofen should be avoided.

Alerting family and friends of the problem will help them assist you in the event of an attack. If you feel an attack coming on, stop doing anything that might put you at risk of injury.

Meniere’s disease isn’t curable but it isn’t fatal either. Treatment can be effective and lifestyle adjustments can be made to minimize problems.