Meniere’s Disease and Hydrops

Meniere’s Disease is a problem of the inner ear that affects both hearing and balance. Although its cause is unknown, one of the current theories about it is that it may be, or may be associated with, an auto-immune problem affecting the inner ear. Doctors estimate that they diagnose between 50,000 and 100,000 new cases of Meniere’s Disease each year.
 

How Meniere’s Disease Affects the Ear

Your inner ear contains fluid-filled tubes called labyrinths or semi-circular canals. These tubes interact with a nerve in the skull to help you keep your balance.

However, for reasons that aren’t fully understood, sometimes the endolymphatic sac, which is a part of the system of labyrinths, becomes swollen. The onset usually is sudden, unexpected, and—especially the first time—frightening.
 

Symptoms

The first symptom is a sudden feeling of “fullness” or swelling inside one ear, accompanied by a partial or complete loss of hearing on that side. At the same time, the patient experiences severe dizziness or vertigo. The increase in pressure in the ear also can damage the outer hair cells of the ear, which results in sudden-onset high pitched tinnitus.

The symptom that is the most debilitating is the vertigo. Patients may experience nausea, vomiting, and an inability to walk. Some patients are bedridden during attacks, which may last from a few minutes to several hours.

In a related condition known as hydrops, the patient experiences every symptom except the vertigo. With both hydrops and Meniere’s Disease, each attack can damage more hair cells, leading to progressive hearing loss and worsening tinnitus. However, once the actual attack passes, your hearing may return almost to normal except for continued tinnitus.
 

Diagnosis and Treatment

It’s important to determine whether the vertigo the patient is experiencing is from Meniere’s Disease or some other cause. Your doctor will do neurological tests, hearing tests, and at CT scan or MRI.

Hydrops is rarer than Meniere’s Disease, and harder to diagnose; once other causes of tinnitus have been eliminated, your doctor may make the assumption that you have hydrops and treat you for it. If your symptoms improve, then that’s a good indication that you have hydrops.

Neither Meniere’s Disease nor hydrops can be cured. However, they can be treated, both with medication and with lifestyle changes.

The first change is to reduce the salt in your diet. The maximum amount recommended for most healthy adults is 2500 mg a day; both Meniere’s and hydrops patients should try to maintain a level of no more than 1000 mg a day. Also avoid aspirin, caffeine, artificial sweeteners, and anything else that may make tinnitus worse. Medications such as diazepam can help with vertigo, and also help reduce stress, which can worsen symptoms.

If you suffer from Meniere’s and have vertigo, you may need help walking during an attack (if you can walk at all; not everyone can). Try not to do anything that worsens symptoms, such as watching TV, reading, or making any sudden movements. Rest until you are able to move comfortably again. Do not drive, climb, or operate any kind of equipment during or for a few days after an attack; a dizzy spell while you’re doing any of these things can endanger both you and others.

If your vertigo is severe and doesn’t respond to treatment, you can have surgery to cut the vestibular nerve. As a last resort your surgeon can remove part of the inner ear to control the vertigo; however, this causes complete hearing loss.

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What To Expect

The outcome of both Meniere’s Disease and hydrops varies from patient to patient. In some patients the condition may be disabling. It may get better on its own, or not. In severe cases, the patient may experience severe hearing loss. However, many patients are able to manage their condition with medication and changes in lifestyle.