Meniere’s disease is a disease that affects the inner ear and can cause sudden attacks of dizziness. Fortunately over time the attacks will most likely get better. This article aims to outline the condition and give you information re what you should do if you have these symptoms.
What is it?
This is a medical condition that affects ones ears and can cause attacks of hearing loss accompanied with dizzy spells. This can be due to having too much of a particular type of fluid called lymph in your inner ear.
When you are having an attack of Meniere’s disease you can expect to have a loss of hearing and you will most likely feel as though the room is spinning, something that in medicine we call vertigo. Another symptom that may accompany these other two symptoms is something known as tinnitus which is a ringing or humming in your ear. Collectively these three symptoms make up the triad that is Meniere’s disease i.e. hearing loss, vertigo and tinnitus. But not all of these symptoms have to occur for Meniere’s disease to be present. Sometimes one may also feel pressure in their ears when they are having an attack. This is a very unpleasant experience and often people with this condition who are having an attack will feel sick and want to vomit and lie down. The attacks can last anywhere between 20 minutes to several hours and afterwards people often feel tired or unsteady. Many people get around 12 or more attacks per year, but others have them far less frequently.
Those with this condition have variable amounts of hearing loss and some people do not have any hearing deficit in between attacks, whereas others may have little or no hearing. The symptoms associated with this condition can start in one ear but after a while the symptoms may spread to the other ear also. These symptoms are not always caused by meniere’s disease and other causes may include an ear infection or anemia. You should see your doctor right away if you get hearing loss or dizziness. Your doctor may do various tests on you to ensure that you have meniere’s disease and not any other condition.
The treatments of meniere’s disease are not well researched and as such there is not very good evidence to support them. As always in medicine there are things that you can try and these may or may not work. Some of the treatments are aimed at the period when you are having an attack and others are used for the prevention of another attack.
The treatments that try to prevent attacks include changing the way in which one lives. In this treatment method patients will be directed to eat a low salt diet, give up smoking, exercise, avoid foods that are high in caffeine and stop drinking alcohol. This is obviously a big ask for patients and there is not even very good research to back this method up. The only real thought is that a low salt diet may help lower the amount of fluid in the inner ear, but even this is not certain.
Balance training is a form of physiotherapy, which uses head and body exercises in the attempt to alleviate symptoms. Diuretics are drugs that assist in getting rid of excess fluid in your body and two of these drugs in combination are found to be relatively effective in meniere’s disease. The combination is called co-triamterzide however this does have some side effects including rashes, dizziness or stomach upsets. Betahistine is another fluid lowering medication but this one focuses more specifically on the fluid within the inner ear. Unfortunately the evidence and research is not very good on this medication and thus it is not widely used. Trimetazidine is a relatively new medication that is used in people with heart disease and some believe that it may help in meniere’s disease. When you visit the doctor they may prescribe for you an anticholinergic drug such as hyoscine. This is a medication that is used in sea-sickness and some research has shown that it helps with the dizziness but unfortunately this was not a great study and thus we can’t be sure of the actual benefits. Also they have side effects including blurred vision, drowsiness, dry mouth and light sensitivity. Benzodiazepines may be recommended during an attack but these can have serious side effects and you can become addicted to them.
In some instances surgery is considered in those with very severe disease. This may include an injection of antibiotics into your inner ear or an operation involving the inner ear, but this surgery is awfully uncommon and risky if hearing is to be preserved.
Symptoms in this condition as a rule generally come and go and many get better without any treatment. Because most people get better spontaneously it is hard to day just how much the various treatment methods help. Attacks usually occur with the highest frequency during the early stages of the disease but after a number of years two out of every three people find that their dizziness disappears. Unfortunately even though you may get rid of the dizziness it is likely that you may have some hearing loss or continue to have ringing in the ears. Hearing aids can often restore the hearing loss and your doctor can help you with the ear ringing. Because this can cause dizziness you must ensure that you tell your doctor about it as this can affect your safety at home or whilst driving or operating heavy machinery.