Meniere’s disease is a rare inner ear disorder that affects one’s balance. An anomaly in the balance organ of the ear called the labyrinth is responsible for the disease. Triggered by fluid accumulation, the disorder can induce symptoms like severe spinning sensation, dizziness, impaired hearing, and a feeling of pressure in the ear. The condition can develop at any age, however, it is more common among adults between 30 and 60.

Understanding the condition

People with Meniere’s disease commonly experience symptoms during abrupt attacks that last two to three hours. However, these symptoms may disappear completely after a day or two. The signs and symptoms vary depending on the severity of the condition. Some persons may experience frequent rounds of vertigo and hearing loss, while others may experience severe tinnitus (ringing sound in the ear) with moderate vertigo. Other symptoms include hearing sensitivity (hyperacusis) and distorted sound.

Stages and associated symptoms

Usually, Meniere’s disease symptoms are categorized into three stages to distinguish them on the basis of severity. Patients may not go through all three stages, and some people may find relief after stage 1, whereas severe forms of MD may begin with all the indicators of stages 2 and 3.

Early stage: Here, vertigo attacks come and go. During an attack, one may feel unsteady or as if they are spinning or their surroundings are moving uncontrollably. People may experience varying levels of deafness in the affected ear and an increase in tinnitus. Tinnitus is often the first symptom that acts as a warning sign of an attack.

Middle stage: The most common symptoms here are tinnitus, vertigo, and hearing loss. People experience vertigo that comes and goes with the episodes becoming less severe. Frequent periods of imbalance and giddy movement can be observed as precursors to an attack. Permanent hearing loss, as well as severe tinnitus, can be noticed at this stage.

Third stage: The stage is characterized by tinnitus, hearing loss, and balance issues. The hearing loss worsens as the disease progresses, although vertigo episodes reduce or end entirely. One may experience discomfort due to loud sounds or distortion of specific sounds, potentially causing substantial long-term damage to the balancing organ. This results in a constant sense of instability, especially while moving in the dark or dancing, and hearing issues that last longer than an attack episode.

Causes

Meniere’s disease can develop due to abnormalities in the physiology or fluid levels of the inner ear. The organs of balance and hearing are housed in the labyrinth, which is segregated into two parts—the bony labyrinth and the labyrinthine membrane. The membranous labyrinth is surrounded by bone and contains a fluid known as endolymph, which moves with the head. This prompts nerve receptors in the membranous labyrinth to send information to the brain regarding body movement. Excess endolymph in the labyrinth can disrupt the proper transmission of balance and hearing information between the inner ear and the brain. However, the precise cause that triggers these changes remains unknown. Fluid accumulation could be brought on by these factors:

Infections and allergies

Abnormal immune system response

Injuries to the head

Genetic danger

Abnormal fluid drainage due to a blockage

Migraine attacks

Viral inflammation

Certain kinds of pressure and emotional disturbances, working too much for too long, existing health conditions, and weariness, might trigger Meniere’s disease. Further, excessive salt consumption could be a possible trigger as it can cause ear pressure fluctuations.

Managing the disease

Meniere’s disease treatments can help people manage the symptoms; however, there is no permanent cure for the illness. Effective ways to treat and manage the disease include:

Lifestyle changes : Anxiety and stress reduction can reduce symptoms’ severity. Yoga, meditation, tai chi, and mindfulness may help people relax.

Food-related modifications: This includes limiting one’s salt intake (by reducing junk food), regularly drinking water and other fluids, evenly distributing small meals throughout the day, and avoiding unhealthy lifestyle choices.

Prescription options to treat symptoms: Meclizine and diazepam are two treatment options used for relieving motion sickness. Prochlorperazine (Compazine) is an effective option for relieving nausea during a vertigo episode. Further, diuretics lower fluid retention in the body, which can be prescribed by the doctor. Another popular option is Pycnogenol for Meniere’s disease can help relieve tinnitus symptoms in a short period by increasing cochlear blood flow.

Balance practice : People with Meniere’s disease can opt for vestibular rehabilitation therapy. Patients can experience balance issues during episodes of vertigo. A healthcare expert can guide patients using workouts and activities to help their bodies and brains regain the ability to process balance.

Surgery: This option can be considered if alternative therapies have failed or if symptoms are severe.

However, the effectiveness of surgery remains unknown and is being studied. Depending on the severity of the symptoms and whether one or both ears are damaged, surgical treatment options like endolymphatic sac decompression and labyrinthectomy may be recommended.