A disorder of the inner ear causing sudden episodes of severe dizziness, nausea, and hearing loss
- Most common between the ages of 20 and 60
- Sometimes runs in families
- A high-salt diet may increase the frequency of attacks
- Gender is not a significant factor
Ménière’s disease is a rare disorder of unknown cause, although it may be related to excessive fluid pressure in the inner ear. The condition causes sudden attacks of distorted hearing and dizziness so severe that the affected person may fall to the ground.
Usually only one ear is affected, but both ears can become involved. The condition most commonly occurs in people aged between 20 and 60 years and sometimes runs in families. Ménière’s disease may lead to permanent hearing loss.
What are the symptoms?
Attacks of Ménière’s disease occur suddenly and may last from a few minutes to several days before gradually subsiding. The symptoms may include:
Sudden, severe dizziness and loss of balance (see Vertigo).
Nausea and vomiting.
Abnormal, jerky eye movements.
Ringing or buzzing noises in the affected ear (see Tinnitus).
Loss of hearing, particularly of low-pitched sounds.
Feeling of pressure or pain in the affected ear.
The length of time between attacks of Ménière’s disease ranges from a few days to years. Tinnitus may be constant or may occur only during an attack. Between attacks, vertigo and nausea cease and hearing may improve. With repeated attacks, hearing often deteriorates progressively.
How is it diagnosed?
Your doctor may arrange for hearing tests to assess your hearing loss. He or she may also arrange for a caloric test, in which air or water at different temperatures is introduced into the ears to check the functioning of the organs of balance. A tumour affecting the nerve that connects the ear to the brain (see Acoustic neuroma) may occasionally produce symptoms that resemble those of Ménière’s disease. Your doctor may arrange for you to have tests such as CT scanning or MRI to rule out the possibility of a tumour.
What is the treatment?
You may be prescribed drugs to relieve nausea (see Antiemetic drugs). Your doctor may also recommend an antihistamine to give further relief from nausea and vertigo and to reduce the frequency of the episodes. Sometimes, diuretic drugs are used to help prevent further attacks.
There are steps you can take to help yourself if you have Ménière’s disease. During an attack, lie still with your eyes closed and avoid noise, perhaps by wearing earplugs. Between attacks, try to avoid stress. Relaxation techniques may also be helpful.
For people who continue to have severe vertigo and whose hearing is already significantly impaired, one of various other options may be recommended. One course of action involves applying the antibiotic drug gentamicin to the middle ear. More invasive procedures include cutting the vestibular nerve (which carries information about position and motion to the brain) or surgically destroying the labyrinthine structure in the ear.
What is the prognosis?
The symptoms of Ménière’s disease usually improve with medication. The frequency and severity of the episodes tend to decrease over a period of years. However, hearing usually worsens progressively with each successive attack, and permanent hearing loss may result, although total deafness does not usually occur.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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