Meniere’s disease is an inner ear problem that can cause vertigo and hearing loss. In most cases, Meniere’s disease affects only one ear.

Meniere’s disease can occur at any age, but it usually begins between the ages of 40 and 60. Experts believe that this condition lasts a lifetime, but some treatments can help relieve symptoms and reduce their long-term impact on a person’s life.

symptoms

Symptoms of Meniere’s disease include:

• Regular dizzy spells. The patient feels dizzy that starts and stops suddenly. Dizziness may begin without any warning sign. It usually lasts from 20 minutes to 12 hours, but no longer than 24 hours. Severe dizziness can cause nausea.
• hearing loss. Hearing loss associated with Meniere’s disease can come and go, especially early in the disease. Over time, hearing loss may become a long-term condition that does not improve.

Ear ringing. Ringing in the ears is known as tinnitus. This term refers to hearing ringing, buzzing, roaring, whistling or hissing sounds.

• Feeling of ear blockage. People with Meniere’s disease often feel pressure in the ear. This is known as an ear blockage.

Symptoms improve after the dizziness episode ends, and may disappear for some time. Over time, the number of dizzy spells you experience may decrease.

When do you see a doctor?

Consult Dr. Ghaith Khurshid if you have symptoms of Meniere’s disease. Other diseases can cause these problems, so it is important to find out the cause of these symptoms as soon as possible.

the reasons

The cause of Meniere’s disease is unknown. Symptoms of Meniere’s disease may be caused by excess fluid in the inner ear called endolymph. But why this fluid builds up in the inner ear is still not clear.

Problems affecting the fluid that may contribute to Meniere’s disease include:

• Not draining fluids well. This may be due to a blockage or an irregular shape of the ear.
• Autoimmune disorders.
• viral infection.
• hereditary characteristics.

Because no specific cause has been identified for Meniere’s disease, it is likely caused by a combination of causes.

complications

More severe complications from Meniere’s disease may include:

Sudden bouts of vertigo

• Possible long-term hearing loss

The disease can occur at any time; This may cause feelings of anxiety and stress.

Dizziness can lead to loss of balance. This may increase the risk of falls and accidents.

Diagnosis

The doctor will examine you and ask you questions about your medical history. A diagnosis of Meniere’s disease should include:

• Two or more episodes of dizziness, each lasting between 20 minutes and 12 hours, or up to 24 hours.
• Hearing loss confirmed by a hearing test.

Tinnitus or a feeling of ear blockage or pressure.

Meniere’s disease may have similar symptoms to other diseases. So your doctor will need to rule out any other conditions you may have.

Hearing evaluation

Hearing test is known as audiometry. An audiometry test reveals how well you can hear sounds with different pitches and pitches. It may also test your ability to distinguish between words that sound the same. People with Meniere’s disease often have problems hearing low frequencies or both high and low frequencies, but they may be able to hear sounds in the middle frequencies normally.

balance assessment

Most people with Meniere’s disease return to normal between episodes of dizziness, but you may experience some persistent balance problems.

Tests that examine how well the inner ear is working include:

• Electro-nystagmus or video nystagmus. These tests measure balance by examining eye movement. Part of this test examines the eye’s movement as it follows a target. Another part of it examines eye movement while holding the head in different positions. A third test, known as the thermal test, tracks eye movement by using changes in temperature to elicit a reaction from the inner ear. Your doctor may use warm and cool air or warm and cool water in the ear to perform the thermal test.

Rotary chair examination. Similar to video nystagmus, this test measures how well the inner ear is working based on eye movement. The person sits on a computer-controlled chair and rotates from side to side, triggering inner ear activity.

• Testing the muscular stress created by vestibular stimulation. This test uses sound to activate parts of the inner ear, and records how well muscles respond to that sound. It may show changes that are common in the affected ears of people with Meniere’s disease.
• Computerized motor body position planning. This test shows which part of your stability system you rely on the most, and which parts may be causing your problems. Parts of the stabilization system include vision, inner ear function, or sensation in the skin, muscles, tendons, and joints. You will stand barefoot on a platform wearing a seat belt. Then you will have to maintain your poise in different circumstances.
• Video head pulse test. This test checks how well the eyes and inner ear work together, and uses video to measure the eyes’ reactions to sudden movement. You will focus on a specific point, while rotating your head quickly and with unpredictable movements. And if your eyes move away from the target when you turn your head, this is a sign that you have a reflex problem.

Cochlear electromyography. This test examines how the inner ear responds to sounds. It can help detect fluid buildup in the inner ear, but it isn’t used to diagnose Meniere’s disease alone.

Other case exclusion tests

Lab tests, x-rays, and other tests may be done to rule out conditions. Other conditions can cause problems like Meniere’s disease, such as a brain tumor or multiple sclerosis.

treatment

There is no cure for Meniere’s disease. Certain treatments can help reduce the severity and duration of vertigo attacks. But there are no cures for permanent hearing loss. Your doctor may be able to suggest treatments to prevent your hearing loss from getting worse.

Vertigo medications

Your doctor may prescribe medications to take during an episode of vertigo to make it less severe:

Motion sickness medications. Medications such as meclizine (Antivert) or diazepam (Valium) may reduce the feeling of dizziness and help control nausea and vomiting.

• Anti-nausea medications. Medications, such as promethazine, may control nausea and vomiting during a vertigo episode.
• Diuretics and betahistine. These medications may be used together or separately to relieve dizziness. Diuretics reduce the amount of fluid in the body, which may reduce the amount of excess fluid in the inner ear. While betahistine relieves symptoms of vertigo by improving blood flow to the inner ear.

Long-term use of medications

Your doctor may prescribe medication to reduce fluid retention and suggest that you limit your salt intake. This helps control the severity and extent of the symptoms of Meniere’s disease in some people.

Non-surgical treatment methods

Some people with Meniere’s disease may benefit from nonsurgical procedures, such as:

• Qualification. If you’re having balance problems between episodes of vertigo, vestibular rehabilitation therapy may help improve your balance.
• Hearing aids. Fitting a hearing aid in the ear affected by Meniere’s disease may help improve your ability to hear. The doctor can refer you to an otologist to talk about the best hearing aids for you.

If conservative treatments don’t work, your doctor may suggest more aggressive treatments.

Middle ear injection

Medications injected and sucked into the middle ear may help relieve vertigo symptoms. This treatment is given in the doctor’s office. Injections can include:

• Gentamicin. It is an antibiotic that damages the inner ear. It works by destroying the diseased part of the ear that is causing the vertigo. The healthy ear then takes over the task of balancing. But there is a risk of hearing loss later.
• Steroids. Steroids, such as dexamethasone, may help control dizzy spells in some people. Although dexamethasone may not work as well as gentamicin, it is less likely to cause hearing loss later.

surgery

If vertigo attacks caused by Meniere’s disease are severe and difficult to tolerate, and other treatments don’t work, surgery may be a possible option. Surgical procedures include:

Lymphatic cyst surgery. The lymphatic sac helps regulate fluid levels in the inner ear. This surgical procedure relieves pressure in the area around the lymphatic sac, which in turn can improve fluid levels. Sometimes the doctor inserts a tube into your ear to drain any excess fluid.

Labyrinthectomy. In this surgical procedure, the surgeon removes the parts of the ear that cause vertigo, causing complete hearing loss in that ear. This allows the healthy ear to be responsible for sending information about balance and hearing to your brain. Doctors do not suggest this surgical procedure unless the patient has a hearing loss or complete hearing loss in the affected ear.

• Department of the vestibular nerve. This procedure involves cutting the vestibular nerve to prevent information about movement from reaching the brain. The vestibular nerve is responsible for sending information about balance and movement from the inner ear to the brain. Therefore, this procedure usually improves vertigo while preserving hearing in the affected ear. Most people need medication to put them into a sleep-like state known as general anaesthesia, and they need to stay overnight in the hospital.