Meniere’s Disease

What is Meniere’s Disease and what are the symptoms?
Meniere’s Disease, also known as Endolymphatic Hydrops, is a chronic disease of the inner ear which occurs as a result of abnormally large amounts of fluid, called Endolymph, collecting in the inner ear. As a result, this places pressure on the vestibular (balance organ) and the auditory systems, resulting in the various symptoms of Meniere’s (1).

What are the symptoms?
During a Meniere’s attack, symptoms often last from 20 minutes to 24 hours. The most common symptoms include (1):

  • Vertigo (an illusion of movement or spinning)

  • Nausea &/or vomiting

  • Fluctuating hearing loss

  • Tinnitus (ringing in the ears)

  • Aural fullness (a feeling of fullness/pressure in the ear)

Symptoms may also include anxiety, palpitations, cold sweats and diarrhoea. 

Some people with Meniere’s disease find that their symptoms are made worse by certain events or situations called triggers, these triggers may include:

  • Dietary issues (caffeine, alcohol or high sodium diet) (2)

  • Stress (3)

  • Fatigue

  • Pressure changes (4)

What causes it?
The exact cause of Meniere’s Disease is not yet known. Many theories have been proposed including circulation problems (5), a viral infection (6), allergies (7), an autoimmune reaction (8), migraine (9) and the possibility of a genetic connection (10). Experts aren’t yet sure what generates the symptoms of Meniere’s Disease. The leading theory is that they result from increased pressure in the ear caused by an abnormally large amount of endolymph in the inner ear and/or from the presence of potassium in the ear of the inner ear where it does not belong. 

How it is diagnosed?

Meniere’s Disease is diagnosed based on the description of your symptoms, a thorough medical history, along with specific tests for this condition. These tests may include an Audiogram (hearing test) and Vestibular Function testing, which is a comprehensive test of your inner ear function. These tests are also often useful to monitor the progression of the disease. Your Physiotherapist will advise you whether you require further testing. 

How is it treated?

Although there is no cure for Meniere’s Disease, there are a variety of treatments which assist in the management of this condition. These include:

  • Medications

  • Dietary Changes

  • Vestibular Rehabilitation

  • Surgery


  

References:

1. Nakashima T, Pyykkö I, Arroll MA, Casselbrant ML, Foster CA, Manzoor NF, et al. Meniere's disease. Nature Reviews Disease Primers. 2016;2(1):16028.

2. Christopher LH, Wilkinson EP. Meniere's disease: Medical management, rationale for vestibular preservation and suggested protocol in medical failure. American Journal of Otolaryngology. 2021;42(1):102817.

3. Soderman ACH, Moller J, Bagger-Sjoback D, Bergenius J, Hallqvist J. Stress as a trigger of attacks in Meniere's disease. A case-crossover study. LARYNGOSCOPE. 2004;114(10):1843-8.

4. Schmidt W, Sarran C, Ronan N, Barrett G, Whinney DJ, Fleming LE, et al. The Weather and Ménière's Disease: A Longitudinal Analysis in the UK. Otol Neurotol. 2017;38(2):225-33.

5. Gussen R. Vascular Mechanisms in Meniere's Disease: Theoretical Considerations. Archives of Otolaryngology. 1982;108(9):544-9.

6. Arnold W, Niedermeyer HP. Herpes Simplex Virus Antibodies in the Perilymph of Patients With Meniere Disease. Archives of Otolaryngology–Head & Neck Surgery. 1997;123(1):53-6.

7. Derebery MJ. Allergy and Meniere's disease. Current Allergy and Asthma Reports. 2007;7(6):451.

8. Greco A, Gallo A, Fusconi M, Marinelli C, Macri GF, de Vincentiis M. Meniere's disease might be an autoimmune condition? Autoimmunity Reviews. 2012;11(10):731-8.

9. Radtke A, Lempert T, Gresty MA, Brookes GB, Bronstein AM, Neuhauser H. Migraine and Ménière’s disease. Is there a link? 2002;59(11):1700-4.

10. Morrison AW, Bailey MES, Morrison GAJ. Familial Ménière's disease: clinical and genetic aspects. The Journal of Laryngology & Otology. 2009;123(1):29-37.