What is Meniere's disease?

Meniere's disease is a disorder that affects the inner ear. It can cause problems with your hearing and balance. There's no cure for the disease, but there are treatments that can help.

Meniere's disease mostly affects adults. Symptoms usually occur as episodes or ‘attacks' of vertigo. Some people have many attacks in a short time, while others have attacks less frequently.

Meniere's disease usually affects only one ear, and can cause hearing loss in that ear.

What are the symptoms of Meniere's disease?

Symptoms related to Meniere's disease are:

• vertigo — feeling dizzy and losing balance, often causing nausea or vomiting
• tinnitus — a buzzing or ringing sound in your ear
• hearing loss — hearing may become muffled before an episode and change throughout the episode
• fullness in the ear — a feeling of pressure or fullness in your ear

Symptoms may start suddenly, or you may have ‘warning symptoms' beforehand such as vertigo or hearing loss before an attack.

Attacks usually last for at least 20 minutes but not more than 24 hours. After the episode, you may feel very tired. Sleeping for a few hours may help you feel better.

Some people with severe Meniere's disease have ‘drop attacks'. This means you suddenly fall but stay conscious. Drop attacks are rare, but if you experience them, they can cause injuries or make you feel anxious or stressed about going out.

What causes Meniere's disease?

The exact cause of Meniere's disease is not known, but it's thought to be related to fluid changes in your inner ear.

A special type of fluid in the inner ear helps you sense movement and maintain your balance. The fluid shifts in response to changes in your movement. These changes are then reported to your brain by the nerves in your inner ear.

In Meniere's disease, the amount of inner ear fluid changes. Over time, this can damage the cells responsible for hearing and balance.

Doctors don't fully understand why this build-up happens, but possible causes include:

• problems with the ear from birth
• genetic ear problems, passed down from parents
• ear infections or injuries

Stress can affect Meniere's disease by making attacks more frequent or severe.

When should I see my doctor?

See your doctor if you have symptoms of Meniere's disease. Having a doctor's diagnosis can help you access effective treatment.

Also see your doctor if you have Meniere's disease and:

• your symptoms make daily life difficult
• your symptoms are getting worse
• you have attacks more often
• you feel stressed or worried about your symptoms

When should I seek urgent care?

You should seek urgent care if you suddenly fall and lose consciousness. This could be a symptom of another serious health issue.

How is Meniere's disease diagnosed?

There is no test to confirm that you have Meniere's disease. Your doctor will ask about your symptoms and medical history and examine your ears.

To diagnose Meniere's disease, your doctor will check:

• if you've had 2 or more vertigo attacks — each lasting at least 20 minutes but not more than 24 hours
• for hearing loss shown by a hearing test
• for tinnitus or a feeling of fullness or pressure in the ear

Your doctor may also refer you for tests to rule out other diseases with similar symptoms. They may refer you for a:

• hearing test
• balance test
• x-ray

How is Meniere's disease treated?

There is no cure for Meniere's disease. Treatments can help manage your symptoms.

Self-care at home

At home you can take steps to reduce attacks. You may be advised to:

• limit the amount of salt in your diet
• avoid caffeine, alcohol and smoking
• manage your stress levels
• take medicines your doctor prescribes

These measures may reduce triggers for attacks. They may also reduce the fluid in your inner ear, so you may have fewer attacks of vertigo. They don't usually help with tinnitus or hearing loss.

Medicines for Meniere's disease

Your doctor can prescribe medicines for Meniere's disease, including:

• vertigo and anti-nausea medicines — these can reduce nausea and vomiting during an attack. They can also reduce dizziness and make you feel more relaxed.
• diuretic medicines — these can help reduce fluid in your body and make you feel less dizzy during an attack. It can also be used as a long-term treatment.

Your doctor may refer you to an ear, nose and throat (ENT) surgeon if you have severe symptoms or frequent attacks. The surgeon may suggest one or both of these treatments:

• An injection of medicine into your eardrum to treat vertigo.
• A medicine that damages the part of your ear that causes symptoms. This can treat vertigo, but may make any hearing loss worse.

There's no clear evidence that herbal supplements will help, although some people try them. Supplements can cause side effects and interact with some medicines, so check with your doctor or pharmacist if it's safe before trying them.

Other treatment options

There are other treatments that may help if medicines and self-care don't work, such as:

• surgery — to drain fluid from your inner ear or to cut the nerve responsible for balance
• hearing aids — may help with hearing loss
• physiotherapy — may help manage vertigo

Talk to your doctor about seeing a therapist if your attacks are triggered by stress or if you feel anxious about attacks.

Living with Meniere's disease

You may find it harder to manage certain daily activities due to symptoms of Meniere's disease. Meniere's disease is unpredictable and can unexpectedly affect your balance and hearing— these senses are required for many everyday tasks.

You may need to modify some of your daily activities. An occupational therapist may be able to help. Be especially careful when climbing ladders or operating heavy machinery.

It's not clear if Meniere's disease affects your ability to drive. Talk to your doctor about driving and if you need to inform the road traffic authority in your state.

What are the complications of Meniere's disease?

Meniere's disease doesn't go away completely and can worsen over time. Symptoms may even become permanent. Sometimes the frequency and severity of attacks may improve or even stop as time passes.

Resources and support

• The Sydney Meniere's Support Group includes a range of articles, webinars, personal stories and information on support groups across Australia.
• The Brain Foundation factsheet discusses symptoms, causes and various options for treatment of Meniere's disease.
• You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.