In 1861, the French physician Prosper Meniere described a condition which now bears his name. Meniere’s disease is a condition affecting the entire inner ear, which includes the labyrinth comprising of both the semicircular canals and the cochlea. About two in a thousand of the population are affected.
Symptoms of Meniere’s DiseaseA typical attack of Meniere’s disease is preceded by a feeling of fullness in one ear. Hearing fluctuation or a buzzing in the ear (tinnitus) may also precede an attack, which generally involves severe vertigo (spinning), imbalance, nausea and vomiting. The average attack lasts two to four hours, although there is much variation in the duration of an episode. Following a severe attack, most people are quite exhausted and need to sleep for several hours.
Some people experience brief “shocks,” and others have constant unsteadiness. Most people with Meniere’s disease are over 40 years of age, men and women being equally affected.
A particularly disturbing symptom is a sudden fall (sometimes called a "Drop Attack") that may occur without warning. Those affected suddenly feel themselves tilted or falling. As this occurs out of the blue, warning severe injuries may result.
Episodes may occur in clusters – several attacks occurring within a short period of time – although episodes may be separated by several years during which most people are free of symptoms. The only symptom during these attack-free periods may be mild imbalance or tinnitus.
Meniere’s disease in the beginning affects only one side but in many cases both ears become affected over time. After 30 years, half the patients with Meniere’s have bilateral disease. In many of those affected, there is a progressive loss of hearing in the affected ear.
Patients with Meniere's disease are noted to be more susceptible to migraine, a feature more common in those who have a family history of the condition.
What Causes Meniere’s Disease?
Basically, medical science still has no complete explanation for Meniere's disease. It is usually attributed to viral infections of the inner ear, head injury, a hereditary predisposition, and allergy.
One common explanation is that an acute attack of Meniere’s disease results from fluctuating pressure of the fluid within the canals of the inner ear. However, the fact remains that we still do not know why Meniere's disease occurs.
How is Meniere’s Disease Diagnosed?
Doctors diagnose Meniere's disease based on a combination of the typical symptoms (usually episodic dizziness and hearing disturbance), special tests (which document that hearing is reduced after an attack and then gets better) and exclusion of alternative causes. The process may include hearing testing (termed audiometry), blood tests (ANA, FTA), and an MRI scan of the head. Electrocochleography (ECOG) may be utilised in difficult cases.
Hearing tests often begin with showing a fluctuating low-frequency sensorineural hearing loss. Over years, this gradually progresses to a “peaked” pattern with both low- and high-tone reduction, and finally a “flat” pattern, typically a loss of about 50 decibels, manifests itself.
Sanjiva Wijesinha - Dr. Sanjiva Wijesinha, Associate Professor at Monash University medical school, writes on health, travel and medical topics.
