Meniere's Disease

Meniere's disease is a disorder of the inner ear. An attack most often starts with ringing in the ears (tinnitus) and a sensation of fullness or pressure in one or both ears. Then severe vertigo, nausea, vomiting, and possibly a migraine headache usually occur. There may also be some hearing loss, especially if the episodes are prolonged and frequent. Occurrences can be incapacitating, lasting from several hours to several days and recurring with varying frequency.

An attack is precipitated by a rise in fluid in the labyrinth area of the inner ear, causing increased pressure and a disrupted sense of balance. Although the underlying cause of the disease is unknown, some experts think that degeneration of hair-like structures in the inner ear, which transmit sound waves, may be responsible. Meniere's usually begins in mid-life and occurs about equally in men and women.

Diagnostic Studies and Procedures

Diagnosis starts with a complete physical, which includes a careful examination of the ears, and hearing tests. You may be instructed to restrict fluid or to take a diuretic to lower the body's fluid volume before taking the hearing test.

In another procedure, the ears are irrigated with water at different temperatures, which causes a whirling sensation and makes the eyes flicker. These eye movements can indicate whether or not the labyrinth is diseased.

In some cases, a doctor may order electrocochieography, a test performed under general anesthesia, in which a probe is inserted through the eardrum to measure electrical activity.

Medical Treatments

Medication cannot cure Meniere's disease, but taking a diuretic to rid the body of excess fluid may help prevent attacks, to alleviate an episode, a doctor may prescribe:

Antihistamine drugs, such as diphenhydramine (Benadryl), meclizine (Antivert), or cyclizine (Marezine), which can help to ease the vertigo. Tranquilizers such as diazepam (Valium) may have a similar effect. Antinausea drugs, such as dimenhydrinate (Dramarrune) or scopolamine (Transderm Scop), to ease nausea and vomiting. Steroids, such as prednisone, if an autoimmune cause is suspected. Since taking anything by mouth can be impossible during an attack, drugs may be given in the form of a skin patch, a suppository, or an injection.

Surgery is sometimes recommended if attacks are disabling. The simplest procedure involves drilling a hole through the bone of the middle ear into the labyrinth to release the excess fluid. Removal of a nerve in the ear's vestibular system may alleviate the vertigo and usually does not damage hearing. However, if total hearing loss has already occurred, complete removal of the labyrinth may be recommended to eliminate the vertigo.

Alternative Therapies

Acupuncture. Symptoms are sometimes alleviated in a single session, and a series of treatments may reduce the frequency of attacks.

Herbal Medicine. Ginger tea is said to alleviate nausea and dizziness. Butcher's broom and belony, taken in extract or capsule form, may also help.

Nutrition Therapy. A low-salt diet can reduce excess body fluid, which may in turn reduce the frequency and severity of Meniere's attacks. Caffeine, alcohol, and chocolate can worsen symptomsand should be avoided. Some people have been helped by reducing fat intake to less than 10 percent of calories and increasing their consumption of fresh vegetables and fruits and whole grains. Improvement may be seen within two to three weeks.

Self-Treatment

During an attack, you should stay in bed in a darkened room, lying as still as possible. Sip flat ginger ale to help alleviate nausea and dry mouth.

It is extremely important to protect the ears from any further damage to the hair-like structures that are instrumental in hearing. Wear earplugs when you are in a noisy environment or when using noisy equipment or appliances, including a vacuum cleaner and hair-dryer. If your job involves using a jack-hammer or other noisy machine, wear protective occupational earmuffs. Do not subject your ears to any device that delivers sound directly into the ears through earphones or plugs.

Other Causes of Vertigo and Hearing Loss

Vertigo may also be the result of an inner ear infection, motion sickness, allergic rhinitis, high doses of aspirin and other drugs that damage the inner ear, a blow, to the head, a vascular disorder in the brain or, less commonly, multiple sclerosis. Hearing loss also may be caused by a brain tumor, a stroke, trauma, a viral infection, or nerve damage.