Definition

Meniere disease is a disorder of the labyrinth in the inner ear that causes vertigo, tinnitus (ringing in the ears), and hearing problems. The labyrinth is a system of cavities and canals in the inner ear that affects hearing, balance, and eye movement.

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Causes

The cause of Meniere disease is unknown, but it is thought to be a combination of factors. Possible causes include:

• Rupture in part of the labyrinth, which allows fluid in different compartments to mix
• Scar tissue, which may cause a blockage in the labyrinth and build-up of fluid
• Inner ear injury

Risk Factors

Meniere disease is more common in adults aged 30-60 years, and in Caucasians. Other factors that may increase your chance of Meniere disease include:

• Family history
• Viral infection
• Autoimmune disorders
• Barometric pressure change
• Stress
• Hormonal disorders
• Allergies
• Excess salt in the diet

Symptoms

Meniere disease may cause fluctuating symptoms, which may come on suddenly. They typically involve only one ear, but may involve both. Symptoms include:

• Episodes of vertigo, a spinning sensation while standing still. Episodes may last 20 minutes to 3 hours. Vertigo may be accompanied by:
  • Nausea or vomiting
  • Sweating
  • Paleness of the skin
  • Weakness or falling
  • In some cases, headache or diarrhea
• Fluctuating hearing loss
• Ringing in one or both ears—tinnitus
• Feeling of fullness or pressure in the ear
• Poor sense of balance
• A tendency for symptoms to worsen with movement

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. This will include an examination of your ears and a neurologic exam to evaluate for possible nerve damage.

Tests may include:

• Blood tests—to rule out other causes of the symptoms
• Hearing test
• Electronystagmogram—looks for abnormal eye movements
• Auditory brainstem response
• Electrocochleogram—to check function of the hearing organ in the inner ear
• MRI scan —to look at internal structures of the ear

Treatment

There is no cure for Meniere disease. Treatment focuses on managing your symptoms. Talk with your doctor about the best treatment plan for you. Options may include one or more of the following:

Prevention

There are no current guidelines to prevent Meniere disease. However, to help reduce your risk, avoid:

• High-salt diets
• Excess alcohol
• Stress
• Smoking
• Avoid medications that can be toxic to the ear