Meniere's disease is a disorder of the labyrinth in the inner ear. The labyrinth is a system of cavities and canals in the inner ear that affects hearing, balance, and eye movement.
The Inner Ear
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An increase in the volume or pressure of fluid in the labyrinth can result in Meniere's disease. The cause of these fluid changes is unknown. Possible causes may include:
Part of the labyrinth ruptures, allowing fluid in different compartments to mixScar tissue causes a blockage in the labyrinth
Inner ear injury due to:
, a sexually-transmitted disease
Autoimmune disordersBlood vessel problemsHigh cholesterol
in the blood
Medications, such as antibiotics and
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors for Meniere's disease include:
Age: 20 to 60Race: CaucasianFamily history of Meniere's diseaseStressAllergiesExcess salt in the dietExcess noise
The intensity of symptoms can vary from one person to another. Symptoms usually come on suddenly. They typically involve only one ear, but may involve both.
Symptoms may include:
(spinning sensation), often accompanied by:
Nausea or vomitingSweatingPaleness of the skinWeakness or falling
In some cases, headache or
diarrheaHearing loss may worsen during attacks of vertigoTinnitus
(ringing in the ears)
Feeling of fullness or pressure in the earPoor sense of balanceA tendency for symptoms to worsen with movement
The doctor will ask about your symptoms and medical history, and perform a physical exam. This will include an examination of your ears and a neurologic exam to evaluate for possible nerve damage.
Tests may include:
Blood tests—to check for an underlying causeHearing test
—this is also called an audiometry
Electronystagmogram—a type of eye movement testAuditory brainstem response—measures electrical activity in the hearing nerve and brain stemElectrocochleogram—measures electrical response of the inner ear to soundMRI scan
—a test that uses magnetic waves to make pictures of structures inside the ear
Treatment may include:
These may help limit symptoms:
Bed-rest during acute attacks of vertigo
Avoid foods that are high in
and high in
sugarDrink adequate fluidsPromptly begin replacing fluids lost to heat or exercise
Avoid caffeine, aspirin, and
smokingMinimize stressAvoid medications that seem to bring on or worsen symptomsConsider a hearing aid, if necessaryConsider masking devices (white noise) to limit the effects of tinnitusTake safety measures to avoid fallingRestrict chocolate consumptionReduce alcohol intake
Your doctor may suggest specific vestibular exercises. These exercises use a series of eye, head, and body movements to get the body used to moving without dizziness. You may work with a physical therapist to learn these.
Drugs to treat vertigo, such as meclizine or scopolamineAntiemetics—medications to help control nausea
Other medications that may improve hearing, control inner ear swelling, or limit overall symptoms, including:
AntihistaminesCortisone drugs for a short timeAntidepressants or anti-anxiety medicationsDiureticsAminoglycoside therapy (such as streptomycin or gentamicin) to permanently destroy the part of the inner ear that deals with balance
Surgical procedures are not always helpful, and include:
Endolymphatic sac decompression—removal of a portion of inner ear bone and placing a tube in the inner ear to drain excess fluidLabyrinthectomy—destruction or removal of the entire inner ear, which controls balance and hearingVestibular nerve section
There are no specific guidelines for preventing Meniere's disease. However, to help reduce your risk, avoid the following risk factors:
High-salt dietHigh-sugar dietExcess noiseExcess alcoholStressSmokingUse of drugs that can be toxic to the ear such aminoglycosides, aspirin, and quinine
The Merck Manual of Medical Information
ed. Simon and Schuster, Inc.; 2000.
12/3/2010 DynaMed's Systematic Literature Surveillance
DynaMed's Systematic Literature Surveillance
: Hillier S, McDonnell M. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction.
Cochrane Database Syst Rev.
Last reviewed September 2012 by Kari Kassir, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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