Ménière Disease Overview

A disorder of the inner ear causing tinnitus, vertigo, imbalance, hearing loss, and aural pressure.

Fluid in the inner ear that bathes sensory cells and is key to normal balance and hearing.

Unknown cause of a disease or condition.

Sensation of spinning or dizziness.

Roaring, buzzing, or ringing sound in the ears.

Part of the ear containing structures for hearing and balance.

Inner ear structures containing sensory cells for balance and hearing, bathed in endolymph.

Inner ear structure crucial for hearing.

To diagnose Ménière's disease, a person must experience two or more episodes of vertigo lasting 20 minutes to 12 hours, fluctuating hearing loss in the affected ear, and no other explanation for these symptoms.

People with Ménière's disease usually experience hearing loss in the low and mid frequencies of the affected ear. This hearing loss can fluctuate, meaning it can get better or worse at different times.

The symptoms of Ménière's disease usually affect only one ear, making it a 'unilateral' condition.

Episodes of vertigo and other symptoms in Ménière's are called 'attacks' and they can occur in clusters, followed by periods of months or even years without any episodes.

Before a Ménière's attack, people often feel pressure in the affected ear, experience changes in hearing, or notice tinnitus.

Hearing loss in Ménière's disease typically starts with lower frequencies and progresses to involve higher frequencies over time.

As Ménière's disease advances, hearing loss becomes more permanent.

Ménière's disease causes severe vertigo, often accompanied by balance issues, nausea, and vomiting.

Sudden, unexpected falls without warning, lasting seconds to minutes, are a possible symptom of Ménière's.

Besides hearing loss and vertigo, some patients may experience blurred vision, trembling, sweating, rapid heartbeat, and diarrhea.

A feeling of congestion or fullness in the ear, often a symptom of Ménière's disease.

Hearing loss that comes and goes, often a feature of Ménière's disease, particularly before or during dizzy spells.

Problems with balance, such as feeling unsteady or prone to falls, often associated with Ménière's disease.

Devices that emit a constant, low-level sound to mask tinnitus and help people focus.

A therapy that teaches people to live with tinnitus by reducing its perceived loudness and improving coping strategies.

Medications that help prevent or reduce nausea and vomiting caused by motion, often used for vertigo.

A hearing test used in diagnosing Ménière's disease to assess hearing loss.

Tests used to assess balance and inner ear function, not routinely for Ménière's diagnosis, but helpful in ruling out other conditions.

Think inner ear and electrical activity.

A test where the patient stands on a moving platform to assess which balance system parts are faulty.

A test where the patient is placed in a rotating chair to assess inner ear function by examining eye movements.

The primary diagnostic test for Ménière's disease is audiometry (hearing tests). Vestibular function tests are not routinely used for diagnosis but can be helpful to rule out other causes.

Audiometry measures the ability to hear sounds at different frequencies and volumes.

Electrocochleography is a test that measures electrical activity in the inner ear. It can help determine if there is a buildup of endolymphatic fluid, a possible cause of Ménière's disease.

Posturography testing helps assess which parts of the balance system are causing problems by placing the patient on a moving platform.

Rotary-chair testing assesses inner ear function by placing the patient in a computer-controlled rotating chair and observing eye movements.

These help rule out other possible causes of Ménière's symptoms.

A scan that provides detailed images of your brain and inner ear, helping rule out other possible conditions.

Medications like diazepam (Valium) or lorazepam (Ativan) are used to manage anxiety, a common symptom in patients with Ménière's disease.

Drugs like diphenhydramine (Benadryl), dimenhydrinate (Dramamine), or meclizine (Bonine) are used to treat dizziness, motion sickness, nausea, and vomiting associated with Ménière's disease.

Promethazine, a phenothiazine, helps control nausea and vomiting, and can also be used for motion sickness in Ménière's patients.

Diuretics are often prescribed long-term to lower fluid volume and pressure in the inner ear, which helps manage dizziness associated with Ménière's disease.

Betahistine is used to treat symptoms or prevent attacks of Ménière's disease, according to guidelines from the American Academy of Otolaryngology. It works by improving blood flow to the inner ear.

Injecting medications into the middle ear to control vertigo, particularly when other treatments haven't worked.

A type of intratympanic injection using corticosteroids to reduce dizziness, with no risk of hearing loss.

Another type of intratympanic injection, using gentamicin to control vertigo, but carrying a risk of hearing loss.

Intratympanic injections can be either corticosteroids or gentamicin. Corticosteroids are safer for hearing, while gentamicin carries a risk of hearing loss.

Intratympanic injections are used when vertigo hasn't responded to other treatments, offering a targeted approach to the inner ear.

Treatments that don't involve medication, focusing on lifestyle changes, coping strategies, and physical therapies to manage Ménière's disease symptoms.

A type of therapy that helps individuals with Ménière's learn skills to cope with unexpected vertigo attacks and reduce anxiety about future episodes.

A specialized program of exercises designed to improve balance and coordination in individuals with Ménière's who experience imbalance between vertigo episodes.

Modifying your diet to reduce the frequency and severity of vertigo attacks, often by lowering sodium intake and limiting caffeine and alcohol.

Groups that provide information, encouragement, and a sense of community for individuals dealing with Ménière's disease.

A surgery for Ménière's disease that decompresses the endolymphatic sac, a structure that regulates inner ear fluid levels, to help alleviate excess fluid and reduce vertigo.

The surgical removal of the balance portion of the inner ear for Ménière's disease, resulting in the loss of both balance and hearing in the affected ear.

A surgical procedure that involves cutting the nerve connecting the inner ear's balance sensors to the brain, generally performed to correct vertigo while attempting to preserve hearing.

Surgery for Ménière's disease is considered as a last resort when vertigo attacks are severe and debilitating, and all other treatment attempts have been unsuccessful.

In some cases, a surgical shunt may be placed to assist in draining excess fluid from the inner ear.

Classical Ménière's disease is rarely diagnosed in children.

Vertigo in teenagers is often related to factors like stress, neck/shoulder pain, sleep habits, and migraines.

Vertigo attacks can increase during early pregnancy, likely due to fluid changes, but often decrease later.

Women with Ménière's before pregnancy may experience symptom changes, but it's not always worse.

The increase in vertigo attacks during early pregnancy is likely due to a decrease in serum osmolality.

Ménière's disease can be challenging to diagnose in older adults because they may not experience the typical symptoms and often have other health conditions that complicate diagnosis.

Older adults with Ménière's disease might present with severe balance difficulties and unclear dizziness, rather than the classic symptoms of vertigo, hearing loss, and tinnitus.

Dizziness and vertigo are common in older adults, posing a significant risk of falls and injury. While Ménière's disease is one cause, other vestibular disorders and chronic illnesses are also possible.

Vertigo attacks might increase during early pregnancy due to fluid changes, but usually decrease later on. Preexisting Ménière's may not necessarily worsen during pregnancy.

The increase in vertigo attacks during early pregnancy is likely related to a decrease in serum osmolality, a measure of fluid concentration in the blood.

To improve the patient's quality of life by controlling symptoms, mainly vertigo, and educating the patient about the condition, its progression, and treatment options.

Patients should understand the disorder, its progression, ways to relieve symptoms, treatment choices, and what outcomes to expect.

The nurse can observe the patient's gait for unsteadiness, their response to questions or noises to assess hearing, and their ability to walk independently.

The interview should include questions about symptoms like vertigo or tinnitus, current medications, and any related health conditions.

Vertigo in teenagers is often related to stress, neck/shoulder pain, sleep habits, and migraines.

A physical exam for vertigo should include inspecting the outer ear and eardrum for obstructions or infections. Hearing and neurological function should be assessed.

The whisper test, Weber and Rinne tuning fork tests are used to assess hearing acuity in a vertigo evaluation.

The Romberg test evaluates balance, which is crucial for diagnosing vertigo.

Testing cranial nerve function helps in identifying other potential causes of vertigo.

The main goal is to improve the patient's quality of life by controlling vertigo symptoms, educating them about the condition, and providing treatment options.

A type of dizziness experienced by patients with Ménière's disease, leading to anxiety, stress, fatigue, and potential for injury.

To promote safety, reduce anxiety/stress/fatigue, maintain fluid balance, encourage effective coping mechanisms, and educate about health management.

Methods like stress reduction, avoiding caffeine and alcohol, sodium restriction, and lifestyle modifications can help manage Ménière's symptoms.

Methods like meditation with deep breathing, yoga, and exercise can be helpful in managing Ménière's symptoms.

These groups connect individuals with Ménière's, offering information, encouragement, and a sense of belonging.

Helping patients with Ménière's disease develop successful coping strategies to manage their symptoms and reduce anxiety and stress.

Identifying and addressing potential hazards in the home to prevent falls and injuries for patients with Ménière's disease.

Encouraging the use of aids like canes during periods of imbalance to enhance safety and mobility in Ménière's.

Teaching patients to manage vertigo episodes by remaining still and quiet, and avoiding unassisted ambulation until the attack subsides.

Providing information about Ménière's disease, including its progression, symptom management, treatment options, and expected outcomes.