Meniere’s Disease (MD): Symptoms, Causes & Treatment!

Meniere’s Disease is a disorder of the inner ear characterized by varying symptoms & its complication is complete loss of hearing.

Initially only a single ear is affected but over time both the ears may be affected.

Attacks or discomfort suffered in Meniere’s Disease can last from 20 mins to even 24 hours in severe cases, this is called an MD episode/attack.

SIGNS & SYMPTOMS OF MENIERE’S DISEASE

  • Vertigo
  • Ringing in the ear
  • Hypersensitivity to sounds
  • Feeling of fullness in the ears
  • Headache
  • Problems in hearing
  • Blurry vision
  • Nausea & vomiting
  • Sweating
  • Problems in concentration
  • Anxiety.

COMPLICATIONS

  • Problems in balance & co-ordination.
  • Sensation of being sharply pushed on the floor behind.
  • Sudden falls without loss of consciousness
  • Injury due to falls
  • Total hearing loss.

CAUSES OF MENIERE’S DISEASE

There is no single particular cause for Meniere’s Disease.

  • Inflammatory cause
  • It can lead to the filling of the endolymph fluid in the inner ear.
  • This puts pressure on the inner ear.
  • Due to ineffective draining of this fluid from the inner ear, problems in hearing & balance occur.
  • The endolymph fluid interferes with the function of the sensory cells in the cochlea.

RISK FACTORS

  • Blockage or an abnormal structure in the ear
  • Autoimmune disorder
  • Genetics
  • Allergy
  • Viral infection
  • Migraine
  • Trauma to the head
  • Constriction of blood vessels in the ear
  • Environmental factors.

DIAGNOSIS

  1. Audiometric test & speech discrimination: To test the hearing ability of the individual and either ear, therefore similar soundly words are spoken, for eg: ‘fit’ & ‘sit’ & the individual is asked to make distinction.
  2. Electronystagmography (ENG): Measurement of balance & co-ordination of an individual by placement in a darkened room. 
  3. Electrocochleography: Measurement of the pressure of the fluid in the inner ear.
  4. Measurement of electrical signal conducted in the ear & brain.
  5. MRI or CT scan for differential diagnosis & to determine if there is any damage to the brain lobes.

TREATMENT & MANAGEMENT FOR MENIERE’S DISEASE

  • Anti-emetic medications for nausea & vomiting
  • Anti-vertigo medication like betahistine for motion sickness.
  • Anti-anxiety medicines for people who suffer from anxiety due to MD attacks.
  • Use of anti-histamines for management of symptoms related to Meniere’s Disease.
  • Use of diuretics for reduction of fluid buildup in the ear.
  • In cases where there is hearing loss and continuing severe episodes of vertigo, a chemical labyrinthectomy is performed.
  • In the process, a medication such as gentamicin is injected into the middle ear and kills parts of the vestibular apparatus.
  • Reduction in take of salt & caffeine.
  • Counselling & relation techniques.
  • Physiotherapy.
  • Surgery for reduction in pressure in the inner ear by decompression of the endolymphatic sac.
  • Three methods exist:
    a) Simple decompression
    b) Insertion of a shunt
    c) Removal of the sac