Méniere's disease

What is Ménière's disease?

Ménière's disease is a problem of the inner ear – this usually affects just one ear but can spread to both over time. People with the condition often report suddenly feeling dizzy, having ringing in their ears or hearing loss.

What are the symptoms of Ménière's disease?

The symptoms of Ménière's disease are sudden and are often described as ‘attacks’. These symptoms include:

• Feeling dizzy – like you’re moving or the room is moving. This is called vertigo 

• A ringing in your ears – this is called tinnitus 

• Hearing loss – your ears may feel clogged and muffled 

• Feeling unsteady 

• Feeling a lot of pressure in your ear 

• Feeling sick 

If you have Ménière's disease, you may experience what’s called a ‘drop attack’. This is when you have severe vertigo that causes you to fall down from standing.

Once the symptoms have started they typically last 2 to 3 hours before resolving, but they may not go away completely for a couple of days after onset. The symptoms may leave you feeling tired.

How often attacks occur is different from person to person. They may occur multiple times a week, every few weeks, every few months or years.

Ménière's disease does not affect someone’s life expectancy.

How to prevent Ménière's disease symptoms

There isn’t a specific Ménière's disease diet, but it’s been suggested, although no proof, that a few changes to your lifestyle may help reduce the severity of your symptoms. These include:

• Eating less salt 

• Reducing caffeine 

• Reducing alcohol 

• Stopping smoking

How common is Ménière's disease?

Ménière's disease is a relatively rare condition. A study showed that the likelihood for someone to have Ménière's disease in the UK is 13.1 per 100,000 person years. 

What causes Ménière's disease?

It’s not known what triggers Ménière's disease, but the symptoms are likely to be caused by the buildup of fluid in the ear. This fluid is called endolymph. Endolymph collects in the inner ear, and this part of the ear is called the labyrinth.

The labyrinth is made up of two main components. The first are semicircular canals which are the areas that are involved in balance, the second is the cochlea which is the structure responsible for hearing. In Ménière's disease, the buildup of fluid interrupts normal balance and hearing.

How is Ménière's disease diagnosed?

Ménière's disease is most often diagnosed by an ear, nose and throat (ENT) doctor. There are no specific tests for this condition but a diagnosis will be made based on your symptoms and questions you are asked about your overall health.

Doctors will ask about whether you have these key symptoms:

• Dizziness where the room or yourself feels as though its spinning, known as vertigo 

• Ringing in your ear, known as tinnitus 

• Changes in your hearing

A GP can examine you and refer you to an ENT specialist if necessary.

How to treat Ménière's disease

Unfortunately, there’s no cure for Ménière's disease so the treatment is largely based on managing symptoms. If you are experiencing frequent attacks then a medication called betahistine is often given to try and reduce pressure of the fluid in the inner ear. 

Some medicines that might be offered for an attack include:

• Antihistamines which are used to treat vertigo, nausea and vomiting

• Prochlorperazine which is given if your nausea and vomiting is more severe

Vertigo symptoms often improve with time if you are taking medication to control it.

If your symptoms are extreme, it may be suggested that you undergo surgery to control your condition. This is put in place if all other treatments have failed as there is limited evidence to show that it is effective.

Ménière's disease can also be a very difficult condition to cope with, so services such as counselling may be recommended.

What are some additional risks of Ménière's disease?

Ménière's disease causes you to lose balance and feel dizzy, and because of this, it can make driving very dangerous for you and other road users. It is important that you take advice from your doctor and you must inform the DVLA if you have sudden, unpredictable attacks of dizziness.

In addition to driving, other activities that may cause harm during attack must be carefully considered before being carried out. As attacks are often unpredictable, many people choose to have someone with them if they are in one of these positions.

What are the complications of Ménière's disease?

Complications include:

• Falls brought on by an attack 

• Anxiety caused by the condition

Who is at risk of Ménière's disease?

Ménière's disease has been shown to be more common in women than men. 

Other factors that may increase your risk of Ménière's disease include living with:

• An immune disorder 

• A viral infection

• A head injury

• Migraines 

• A family history of Ménière's disease

Ménière's disease is uncommon in children. 

When should I seek help?

If you are suffering from the symptoms listed above, get in contact with a doctor and you can be advised on the best way to manage Ménière's disease.