Ménière’s disease/syndrome is a long term, progressive vestibular condition affecting the balance and hearing parts of the inner ear. Symptoms are acute attacks of vertigo (severe dizziness), fluctuating tinnitus, increasing deafness, and a feeling of pressure in the ear.

Who is affected by Ménière’s ?

The incidence of Ménière's is between 1:1000 and 1:2000 of the population; depending on the source. Méniére's can affect anyone and it can occur at any age. About 7-10% of those affected have a family history of the condition.

What causes Ménière’s ?

The cause of Ménière’s is unknown. Many factors are thought to be involved in the development of the condition, e.g. increased pressure of the fluid in the endolymphatic sac; allergic factors damaging the inner ear or other unknown factors. The relationship between these factors and the progression of the condition, however, remains unclear.

How does Ménière’s affect you?

Symptoms vary between people and over time. The main problems are unpredictable attacks of vertigo with nausea and vomiting. Attacks can last from a few minutes to 24 hours. There may also be tinnitus, hearing loss and a feeling of fullness in the affected ear. Periods of remission between attacks can vary from days to months or even years; making Ménière’s an unpredictable and distressing condition. As it progresses the vertigo may be less severe; however there may be periods of imbalance, adding to the distress. In the later stages tinnitus is more prominent and fluctuating hearing loss develops. There is permanent damage to the balance organ and significant balance problems are common. Usually only one ear is affected, but up to 50% of sufferers may develop the condition in both ears.

Why does tinnitus happen in Ménière’s ?

Ménière’s disease causes damage to the hair cell receptors in the inner ear. These damaged hair cells spontaneously fire and send disorganised signals up the auditory nerve to the brain. In Ménière’s the hair cells concerned with low frequency sound are the first damaged, and therefore the tinnitus in Ménière’s is usually a rumbling, low frequency noise. In a survey in the USA of 51 people with Ménière’s disease, 49% reported the tinnitus as moderately annoying (tinnitus while listening to a speaker) or severely annoying (difficulty with work, relationships and sleeping). For those with Ménière’s disease in its first stages noticing the tinnitus starting to change may be a warning sign that they will have a bad day or an attack.

Why do people with Ménière's get hearing loss?

It is widely believed that Ménière’s develops as a result of an increase in the pressure in the endolymphatic space. The symptoms of ear fullness and reduced hearing are likely to be related to this increase in pressure. The sudden release in pressure accounts for the sudden attacks of vertigo. Repeated episodes of high pressure and sudden releases of that pressure damage the delicate structures of the inner ear and the balance structures of the semi-circular canals. This cumulative damage results in a decline in hearing levels over time.

Why is there a feeling of fullness / pressure in the ear?

Another characteristic of Ménière’s is the sensation of ‘fullness’ or aural pressure which can be incredibly uncomfortable. Some patients tell us they can gauge their condition is starting again if they notice a change in the sensation of the ‘fullness’. The fullness can also fluctuate with the acuteness of the condition. For some people this sensation may disappear completely,  however for others it can become chronic with the constant feeling of pressure and this can cause considerable distress.

What investigations are necessary to make the diagnosis?

There is no specific test that, on its own, is reliable in diagnosing Ménière’s. The three main symptoms of vertigo, hearing loss and tinnitus occur in many other illnesses, and these may need to be excluded by tests (e.g. blood tests, MRI scan) before a final diagnosis can be made.

How is Ménière’s treated?

Treatment of Ménière’s is aimed at reducing and controlling symptoms. As Ménière’s is symptomatic, treatment will vary with the needs of each individual and includes medication, vestibular rehabilitation, diet and lifestyle changes, tinnitus management, hearing aids and counselling. In four out of five people non-surgical measures are sufficient to control the symptoms of Ménière’s; however, if vertigo remains a problem surgical procedures can help.

Get further information about Meniere's

Email us (info@menieres.org.uk) for a FREE Meniere's information pack, or call us on 01306 876883 to chat with a member of our team. 

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Please note, the Ménière's Society can provide general information, but is unable to provide specific medical advice. You should always check with your medical professional for information and advice relating to your symptoms/condition.

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