Meniere's Disease

Alternative Names: Vertigo Disease, Endolymphatic Hydrops.

Thousands of people suffer from this troublesome disease that affects the inner ear.  Major symptoms include constant ringing in the ears and vertigo (dizziness).  The disease is caused by overproduction of fluid in the inner ear but the reason for this is not understood.  Theories include food allergies and spasms of the blood vessels, and problems with the immune system.

Incidence; Causes and Development

Meniere's disease affects about 8% of close relatives of those affected, but only 0.1% of the general population.  The disease affects one ear in 85% of patients and both ears in 15%.

Meniere's disease is caused by excess fluid in the inner ear (labyrinth) which contains the balance (vestibular) system.  The labyrinth contains a complex system of canals and chambers, near to which is a thin-walled membranous sac that is filled with a fluid called endolymph and surrounded by another fluid called perilymph.  These two fluids bathe the vestibular and hearing organs and enable a person to maintain their balance and normal hearing.

In cases of Meniere's disease, there is too much endolymph and pressure inside the sac increases until it bursts.  The subsequent mixing of endolymph and perilymph sends confusing messages down the vestibular nerve to the brain, resulting in severe spinning vertigo, nausea, hearing loss, tinnitus, and a feeling of fullness in the ear.

As well as the causes listed below, excess inner ear fluid can be caused by Autonomic Nervous System (ANS) imbalances, blockage of or damage to the endolymphatic structures, viral infection.

Treatment and Prevention

Meniere's disease has been treated with antihistamines, motion sickness drugs, anti-dizziness drugs, diuretics, and vaso-dilators with very little relief of symptoms.  Patients often end up in surgery to get relief.  It is common to have remissions and exacerbations of the symptoms; Meniere's Disease treatment severely challenges doctors.

Triggers

Although the precise cause of Meniere's disease is unknown, there are various known triggers of vertigo: stress, allergies, excess salt intake, caffeine, and migraine headaches and barometric changes in pressure.

Following a proper diet is important.  Some 80% of patients with Meniere's Disease can have their vertigo controlled if they follow a strict diet and take a daily water pill (or diuretic).  Patients should avoid foods that trigger attacks or exacerbate the disease; they should also maintain proper dietary salt intake.  Sodium and potassium are essential for the proper function of nerve cells in the brain and inner ear, but too much sodium can make the inner ear more sensitive or reactive, and thus more susceptible to an attack of Meniere's Disease.

Caffeine, tea and chocolate contain compounds that are believed to constrict blood vessels in the brain and inner ear; decreased blood flow in the inner ear is believed to interfere with endolymph absorption, resulting in endolymph buildup and the symptoms of Meniere's Disease.

Prognosis

As the disease progresses, hearing loss increases and the patient's confidence plummets as these attacks are frustratingly unpredictable.  In 50% of cases, the attacks will subside within two years; in 70% of cases, they will disappear within eight years.