Meniere's Disease

What Is It?

Ménière's disease is a disorder in which fluid collects in the inner ear. Pressure from the buildup of fluid and damage to some of the delicate structures in the inner ear can cause a variety of symptoms, including:

• Vertigo, the sensation that the room is spinning or rocking
• Dizziness or loss of balance
• Nausea and vomiting
• Tinnitus, the sensation of ringing in the ears
• Hearing loss

The symptoms appear suddenly, without warning, and can last minutes to hours. Many people experience only mild symptoms, but in others the symptoms are severe enough to be disabling. Hearing loss comes and goes, but over time some degree of hearing loss may become permanent.

The cause of Ménière's disease is unknown. It tends to strike men and women equally, and although it can occur at any age, it usually begins between the ages of 30 and 50. In most cases, only one ear is affected. Only about 15 percent of people with Ménière's disease lose hearing in both ears.

Symptoms

Ménière's disease can cause a number of different symptoms related to inner ear function. The type, duration and severity of symptoms vary considerably from person to person. Some patients experience a cluster of attacks for a few weeks followed by years of relief, and other patients experience symptoms regularly for years.

A person with Ménière's disease may experience any or all of these symptoms:

• Vertigo and dizziness, often so severe that it temporarily disables the individual — There may be a sense that the room is spinning, twisting or rocking. Balance can be severely affected. The sensation can last from a few minutes to a full day. After the vertigo goes away, a sense of imbalance can remain for a few more days.
• Nausea and vomiting during an episode of vertigo
• Feeling of pressure or fullness in the affected ear
• Ringing, buzzing or other noises in the affected ear (tinnitus) — The ringing is often low-pitched and may distort normal sounds.
• Hearing loss that comes and goes, but gets progressively worse over time — Low-pitched hearing often is affected earlier in the disease.

Diagnosis

Diagnosing Ménière's disease can be difficult. Your doctor cannot examine the middle ear directly, so there is no simple way to tell if fluid has built up. Usually, your doctor will diagnose Ménière's disease if you experience the typical symptoms and other possible causes of the symptoms have been ruled out.

Your doctor will start by taking a medical history, including information about past or current medical problems and medications that you take. He or she will ask you detailed questions about your symptoms, including when they started, how often and for how long they occur, and how disabling they are. Your doctor then will examine you, with a special focus on your ears, nose, throat and balance system.