Meniere's Disease

Symptoms may include: Episodes of vertigo (spinning sensation), often accompanied by: Nausea or vomitingSweatingPaleness of the skinWeakness or falling In some cases, headache or diarrheaHearing loss may worsen during attacks of vertigoTinnitus (ringing in the ears) Feeling of fullness or pressure in the earPoor sense of balanceA tendency for symptoms to worsen with movement DiagnosisThe doctor will ask about your symptoms and medical history, and perform a physical exam. This will include an examination of your ears and a neurologic exam to evaluate for possible nerve damage. Tests may include: Blood teststo check for an underlying causeHearing test this is also called an audiometry Electronystagmograma type of eye movement testAuditory brainstem responsemeasures electrical activity in the hearing nerve and brain stemElectrocochleogrammeasures electrical response of the inner ear to soundMRI scan a test that uses magnetic waves to make pictures of structures inside the ear TreatmentTreatment may include: Dietary and Lifestyle Changes These may help limit symptoms:

Bed-rest during acute attacks of vertigo Avoid foods that are high in salt and high in sugarDrink adequate fluidsPromptly begin replacing fluids lost to heat or exercise Avoid caffeine, aspirin, and smokingMinimize stressAvoid medications that seem to bring on or worsen symptomsConsider a hearing aid, if necessaryConsider masking devices (white noise) to limit the effects of tinnitusTake safety measures to avoid fallingConsider getting exercise therapy to rehabilitate the inner earRestrict chocolate consumptionReduce alcohol intake Medications Medications include: Drugs to treat vertigo, such as meclizine or scopolamineAntiemeticsmedications to help control nausea Other medications that may improve hearing, control inner ear swelling, or limit overall symptoms, including: AntihistaminesCortisone drugs for a short timeAntidepressants or antianxiety medicationsDiureticsAminoglycoside therapy (such as streptomycin or gentamicin) to permanently destroy the part of the inner ear that deals with balance Surgery Surgical procedures are not always helpful, and include: Endolymphatic sac decompressionremoval of a portion of inner ear bone and placing a tube in the inner ear to drain excess fluidLabyrinthectomydestruction or removal of the entire inner ear, which controls balance and hearingVestibular nerve section Prevention There are no specific guidelines for preventing Meniere's disease. However, to help reduce your risk, avoid the following risk factors:

High-salt dietHigh-sugar dietExcess noiseExcess alcoholStressSmokingUse of drugs that can be toxic to the ear such aminoglycosides, aspirin, and quinine RESOURCES: American Academy of OtolaryngologyHead and Neck Surgeryhttp://www.entnet.org Menieres.orghttp://www.menieres.org CANADIAN RESOURCES: Approaching Menieres Positivelyhttp://www.menieres-disease.ca/ Canadian Family Physicianhttp://www.cfpc.ca/cfp/ References: American Academy of Family Physicians website. Available at: http://www.aafp.org/online/en/home.html . National Institute of Deafness and Other Communication Disorders website. Available at: http://www.nidcd.nih.gov/ . The Merck Manual of Medical Information . 17th ed. Simon and Schuster, Inc.; 2000. Last reviewed December 2007 by Elie Rebeiz, MD, FACSPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.