Meniere's disease
Meniere's disease is a long-term condition of the inner ear that affects hearing and balance, and requires a trio of symptoms to make the diagnosis. About 1 in 1,000 people are affected by it, and it most commonly occurs between the ages of 40 and 60, although it can occur at any age. One ear only is usually affected initially, but about 40% of cases go on to affect both ears. It is named after the French doctor who first described it in the 1860s.
The first symptom is vertigo, where you feel as though the environment is spinning around you, or that you are spinning when you are standing still. The second is tinnitus, a ringing in the ear, and you may also get a feeling of fullness or pressure in your ear. The third is hearing loss that comes and goes, usually affecting one ear at a time.
Meniere's typically comes on without warning, and episodes can last between 20 minutes and 24 hours - although the average length of an attack is 2-4 hours, causing severe nausea or vomiting. Unfortunately, Meniere's is a progressive disease that gets worse over time. The episodes may happen in clusters in a week or over months, or even years, with most sufferers having 6-10 clusters a year. Some people only have vertigo without any hearing loss but hearing loss without vertigo is uncommon in Meniere’s.
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What are the causes of Meniere's disease?
The cause is not well understood – one theory is that changes to the fluid in the tubes of the inner ear causes symptoms. Other possible causes include autoimmune disease, head injury, allergies, viral infections, and genetics.
How can I manage my symptoms myself?
There are only a few things that can be done to relieve symptoms yourself. The first is to be aware of the signs of dizziness and sit down immediately, to help alleviate the sensation. Avoid causing yourself any injuries from falls by walking in good lighting and taking things slow and easy.
Limiting your salt, caffeine, alcohol, and tobacco intake are thought to be effective ways to help reduce the severity of symptoms. After an attack, it usually helps to lie down and rest.
You should not drive during an attack.
What can my doctor do?
Your doctor will examine your ears and the nerves in your head and neck. They will assess your balance, and they can refer you for a hearing test if you have consistent hearing loss.
Further investigations, such as blood tests, and imaging of your head (CT or MRI scan), may be needed to rule out other serious causes of concern, such as multiple sclerosis or a tumor.
What treatments are available?
There is no cure for Meniere's disease, but there are treatments available to help ease symptoms. Your doctor can prescribe medication that can help with vertigo, or nausea and vomiting.
If medication is not managing your symptoms, your doctor will refer you to an ear, nose, and throat (ENT) specialist for further investigation. They may recommend treatments such as rehabilitation, positive pressure therapy, or even surgery.
In about 70% of cases, the attacks will stop 5-10 years after they first started whatever treatment is used.
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