The Methodist Hospital System. Leading Medicine
The Methodist Hospital System. Leading Medicine

Otolaryngology

Meniere's Disease

Balance

The vestibular system:

  • controls balance
  • controls posture
  • regulates locomotion and other movements
  • provides conscious awareness of orientation in space
  • provides conscious awareness of visual fixation in motion

Balance can be impaired by:

  • disease

  • altered gravity

  • aging

  • exposure to unusual motion

When balance is impaired, normal movement is affected, as well as motivation, concentration, and memory.

An estimated 2 million adults suffer from chronic dizziness or difficulty with balance. It particularly affects people aged 65 or older.

Source: National Institute on Deafness and Other Communication Disorders (NIDCD)

What is Ménière's disease?

Ménière's disease is a balance disorder caused by an abnormality found in a section of the inner ear called the labyrinth.

There are an estimated 615,000 people in the US who have Ménière's disease, with 45,500 new cases diagnosed each year.

What causes Ménière's disease?

The labyrinth has two parts:
  • bony labyrinth
  • membranous labyrinth

The membranous labyrinth is encased in bone and contains a fluid called endolymph.

When the head moves, the endolymph also moves, which causes nerve receptors in the membranous labyrinth to signal the brain about the body's motion.

When, for some reason, the endolymph increases, the membranous labyrinth balloons or dilates (a condition called endolymphatic hydrops).

If the membranous labyrinth ruptures, the endolymph mixes with another inner ear fluid called perilymph.

The mixing of the two fluids is believed to cause the symptoms of Ménière's disease.

What are the symptoms of Ménière's disease?

The following are the most common symptoms of Ménière's disease. However, each individual may experience symptoms differently. Symptoms can occur suddenly, or may happen daily or infrequently.

The most debilitating symptom is vertigo, which can cause the patient to have to lie down, as well as:

  • severe nausea
  • vomiting
  • sweating

Other symptoms may include:

  • tinnitus
  • loss of hearing
  • pressure in the affected ear
  • loss of balance
  • headaches
  • abdominal discomfort
  • diarrhea

The symptoms of Ménière's disease may resemble other conditions or medical problems. Always consult your physician for a diagnosis.

Diagnosis of Ménière's disease:

In addition to a complete medical history and physical examination, the physician may request:
  • hearing test
  • balance test
  • magnetic resonance imaging (MRI) scans (to determine if a tumor is present)
  • electrocochleography (to measure electrical activity of the inner ear)

Treatment for Ménière's disease:

Specific treatment for Ménière's disease will be determined by your physician based on:
  • your age, overall health, and medical history
  • extent of the disease
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the disease
  • your opinion or preference

Treatment may include:

  • surgery
    Several types of surgery are effective for treating the balance problems of Ménière's disease. The most common surgical treatment is the insertion of a shunt (silicone tube) to drain of excess fluid.
  • medication
    Medications may be given to control allergies, reduce fluid retention, or improve the blood circulation in the inner ear.
  • change in diet
    Eliminating caffeine, alcohol, and salt may reduce the frequency and intensity of symptoms.
  • behavior therapies
    Reducing stress may lessen the severity of the disease symptoms.