Méniѐre’s disease (MD) is a condition, in which the inner ear is not functioning properly. The inner ear is involved in hearing and also includes the vestibular system. In case of Méniѐre’s disease, attacks of vertigo, hearing loss and tinnitus occur. This condition can have a huge impact on a person’s life.
Cause
The exact cause of Méniѐre’s disease is not yet known. It is obvious that there is a problem with the cochlea. The cochlea is part of the inner ear and is filled with fluid. The cochlea is made up of multiple compartments. The middle and upper compartments are separated by a membrane. In case of Méniѐre’s disease, so much fluid accumulates in the cochlea, that it presses against the membrane. The pressure can be so great that the membrane ruptures. If this happens, the fluid from the middle compartment will flow together with the fluid from the upper compartment. This causes an attack of Méniѐre.
Why the body produces too much fluid in the middle compartment, is not yet known. Ménière’s disease doesn’t seem to be hereditary.
Symptoms
Méniѐre’s disease is mainly characterized by periodic attacks. Initially, there are no symptoms between the attacks. This symptom-free period may vary from several hours to even some years. Over time, part of the patients suffer, also between the attacks, from hearing loss or tinnitus. The frequency of attacks generally diminishes over time. During an attack of Ménière’s disease, a person can experience the following signs and symptoms:
- Vertigo.
- Nausea.
- Vomiting.
- Pallor.
- Sweating.
- A slow heart rate.
- Diarrhea.
- Tinnitus.
- Deformation of sounds.
- Reduction in hearing.
The attacks can become more severe over the years, but they always stop on their own. It’s remarkable that attacks occur more often during rest. Some people feel an attack coming. Early in the disease, the tinnitus is often thumping or buzzing. At a later stage, the tinnitus is often more rustling.
Diagnosis
When the general practitioner suspects Ménière’s disease, he or she will send the patient to an ear, nose and throat (ENT) specialist. The ENT specialist will perform a hearing test. Additionally, for example, a videonystagmography will be done. In some cases, blood tests are performed.
Treatment
Because the exact cause of the disease has not yet been determined, there are only medicines to suppress the symptoms. For example, to counteract vertigo, nausea and vomiting. For patients who have the disease in a serious form, injection of an antibiotic into the middle ear is an effective therapy. Because bright light can trigger vertigo attacks, patients are sometimes advised to wear prism glasses.
Prognosis
The disease can disappear spontaneously, but patients may also keep suffering for years, sometimes with considerable intervals. Over the years, the attacks of vertigo usually subside and the disease mainly leads to permanent hearing loss and very rarely even deafness.
Considerations
- Try to adapt lifestyle, avoid severe stress. Pull the handbrake in time.
- If there is an attack of vertigo coming, the patient can best lie down on a firm, level surface and not move. Try to relax by giving the eyes rest. Watching TV and reading can actually reinforce the attack, just like bright light. Drinking can lead to vomiting, so stay down quietly until the attack is over.
- Don’t rise too quickly afterwards: sudden movements may trigger a new attack. It will be clear that activities like driving, mountain climbing, etc. during an attack are dangerous.
