What is Meniere's disease?

Meniere's disease is a rare disorder of the inner ear. It disturbs balance and may impair hearing. The disease usually affects one ear but may involve both ears. Usually the disorder is mild. Rarely, complete deafness occurs in one or both ears.

How does it occur?

Another term for the inner ear is the labyrinth. It contains structures called the semicircular canals, which sense movement and help you keep your balance. In Meniere's disease the fluid in the inner ear increases, perhaps because it fails to drain properly. The increase in fluid increases pressure in the inner ear. This pressure distorts and may rupture the wall of the inner ear, disturbing your sense of balance.

The part of the inner ear called the cochlea may also be damaged by the pressure. Tiny hairs lining the cochlea change sound into electrical signals. These signals are sent to the brain. If the cochlea is damaged, you may lose some of your hearing, particularly of low tones.

What are the symptoms?

Usually there are no symptoms or the symptoms are mild. However, symptoms can flare up periodically into an attack. The main symptom is sudden, possibly severe dizziness. You may also have the following symptoms with the spells of dizziness:

• a sense of pressure in the affected ear before or during an attack

• ringing noises in the ear (tinnitus)

• deafness or muffled hearing, especially of low tones, in the affected ear

• nausea, retching, and vomiting

• jerky eye movements and difficulty maintaining your vision

• heavy sweating

• in severe cases, anxiety and migraine headaches.

How is it diagnosed?

Tests your doctor may do to determine if you have Meniere's disease are:

• a test of your hearing at various frequencies (audiometry)

• a test in which your doctor stimulates your ear with water at different temperatures to learn if your semicircular canals are damaged

• tests that check the specialized hearing and balance hair cells in the inner ear.

What is the treatment?

Choices of treatment include medications, surgery, and measures you can take to help yourself.

Drugs may be used to reduce body fluid and relieve dizziness, nausea, and ringing in the ears.

One of the following surgical procedures may be performed:

• If your symptoms indicate you have Meniere's disease in just one ear and your symptoms are severe, your doctor may drill a hole to release fluid from the canals of that ear. In about 60% of cases, this operation cures dizziness and prevents further hearing loss. For some people this surgery improves hearing.

• If you have no hearing left in an ear and your dizziness is disabling, your doctor may decide to surgically remove the canals of the inner ear. Because you have no hearing with that ear, there is little to lose with this method. The other ear will help you keep your balance.

If both of your ears are affected, surgery may be performed on the ear that causes the more severe symptoms. This should help control the attacks and dizziness.

See the 'How can I take care of myself?' section for ways you can help yourself.

How long will the effects of Meniere's disease last?

The length of attacks varies from a few minutes to several hours. The frequency of attacks varies from every few days to every few years.

Usually the disorder is mild and goes away on its own without treatment. In long-lasting cases the attacks usually become less severe, but some hearing loss and noises in the ear may continue between attacks. Severe attacks may return and become increasingly serious.

How can I take care of myself?

You can help yourself by:

• lying down and resting during an attack

• following a diet low in salt and caffeine

• drinking fewer alcoholic beverages

• stopping smoking.

Call your doctor if symptoms last, or if you develop new symptoms.

How can I prevent Meniere's disease?

Because the cause of Meniere's disease is not known, there is nothing you can do to prevent the disorder. However, cutting down on the amount of caffeinated and alcoholic beverages you drink and reducing the salt in your diet may reduce the frequency and severity of attacks.