Meniere's Disease was first discovered in 1861 by a French physician named Prosper Ménière, hence the name today of Meniere’s Disease. Meniere’s is a inner ear disorder that causes episodes of vertigo, tinnitus (ringing in the ears), a feeling of pressure in the ear, and sometimes hearing loss.

Meniere’s effects the entire labyrinth of the ear, which includes both semicircular canals and the inner cochlea. You can see in the picture, a normal inner ear and an ear that has Meniere's’s Disease, which is obvious by the swelling of the entire labyrinth area.

Meniere’s Disease is idiopathic disease, meaning the cause of the disease is unknown. Some doctors have their own opinions as to the cause of Meniere's, but opinions are not facts. Most researchers believe that the symptoms of Meniere's in most people are the result of idiopathic endolymphatic hydrops. A system of membranes, called the membranous labyrinth, contains a fluid called endolymph. These membranes can become dilated like a balloon when pressure increases, as seen in the pictures.

This condition is called hydrops. The most prevalent cause of hydrops occurs when the drainage system called the endolymphatic duct or sac, becomes blocked and slowly builds fluid. In some cases, the endolymphatic duct may be also be obstructed by scar tissue from a previous injury, or may be just narrow from birth. Besides a stoppage of drainage pathways, abnormally enlarged fluid pathways into the ear such as the vestibular aqueduct or cochlear aqueduct may also be associated with Meniere's like symptoms.

Some researchers believe that in some patients with Meniere's, the symptoms are the result of a blood vessel pressing upon a nerve. This condition is called vascular compression, or microvascular compression syndrome (MCS), other researchers view this as a separate disease. Some physicians believe that in some patients with Meniere's, the symptoms result from some kind of autoimmune condition. Still others believe that in some patients with Meniere's the symptoms are the result of a virus infection, but studies have yet to confirm this.

Labyrinth with Meniere's Disease

More recent evidence on Meniere’s Disease may contradict known research. Recently, studies have shown that hydrops aren't found in all persons with Meniere’s, and hydrops are also commonly found on autopsy studies of persons who had no Meniere’s symptoms at all. Because Meniere’s Disease occurs in roughly 2 out of 1000 persons, and hydrops are found in 6 out of 100 temporal bones, there is a larger frequency of people with hydrops, then Meniere’s Disease. So, given that data it’s logical to assume that there must be something more than simply hydrops involved in the origin of Meniere's Disease. There are many theories about the cause of Meniere’s Disease, and until the cause is discovered, many treatments will also be explored by physicians.

How Do You Diagnose Meniere's Disease?

The etiology (cause) of Meniere's Disease is unknown, hence it’s given the term of an idiopathic condition. The symptoms of Meniere's Disease are also the symptoms of many other diseases and conditions, which sometimes makes diagnosing this disease challenging. Diagnosing Meniere's Disease is based on a few key symptoms that a typical Meniere's patient will have. A typical Meniere's patient will have episodic dizziness and hearing disturbances and documented hearing tests after an attack showing reduced hearing ability in lower frequency levels which eventually returns to normal again over time. There are currently no diagnostic tests that can identify Meniere's, so a differential diagnosis is used to properly diagnose a person.

A differential diagnosis can be described as ascertaining the patients symptoms, and then one by one, testing for and confirming or eliminating all possible diseases and conditions that may result in those symptoms. The differential diagnosis is very broad and may include: migraines, labyrinthitis, perilymph fistula, congenital ear malformations, syphilis, MS, and others. A person being diagnosed for Meniere's Disease will have various tests in the differential diagnosis process. Some of the most common tests might include; hearing tests, ENG Test (Electronystagmography), ECOG (Electrocochleography), MRI scans, and several blood tests, Auditory brainstem response (ABR), Perilymph fistula (PLF) test, and maybe more depending upon persons individual condition. There is recent evidence that a test called a VEMP (Vestibular Evoked Myogenic Potential) is gaining popularity in aiding in the diagnosis of Meniere's. This test can detect blockages in the saccule portion of the inner ear where many believe that hydrops first start to develop. This test can be very useful because it can detect hydrops even when a patient is currently not symptomatic. For additional information about the VEMP test click here.

Because there is no specific diagnostic test to confirm Meniere's, when all other possible conditions have been eliminated by a differential diagnosis, the patient is then diagnosed as having Meniere's Disease. This may seem somewhat of a basic approach given today's advances in technology, but until the causes of Meniere's Disease is identified, a differential approach to diagnosis will always be used.

How Do You Treat Meniere's Disease?

There is currently no cure for Meniere's Disease, so treatment for Menieres is only symptomatic (treatment for symptoms). There are currently many possible symptomatic treatments that people can try to lessen or help manage their Meniere’s symptoms. Some of the Possible symptomatic treatments are: dietary, lifestyle changes, medications, and if necessary, surgery. Some patients are able to identify triggers that can sometimes induce or aggravate their symptoms. When a trigger is identified, avoidance or treatment of that trigger can reduce the frequency and duration of symptoms and episodes.

If you have an attack, lay down on a firm surface and stay as motionless as possible. Keep your eyes open and fixed on a stationary object on the ceiling or wall. Stay in this position until the severe vertigo (spinning) has stopped, and slowly get up. For most people, after an attack you will feel very tired and need to sleep for a few hours, this is normal. Following an attack, if vomiting persists for more then 24 hours, or if you are unable to drink and keep fluids down, contact your physician. Your physician can prescribe nausea medication , and or a vestibular suppressant medication that will suppress the vomiting and let you drink fluids again.

Medications: Antivert and Ativan are commonly used for vestibular suppressant medications, and Compazine or Phenergan are commonly used medications for nausea. Between attacks, it's also common to prescribe a diuretic medication to help regulate the fluid pressure in the inner ear. This can help reduce the severity and frequency of the Meniere’s attacks.

Many physicians also recommend certain lifestyle and dietary changes to help reduce your Meniere’s attacks. Most physicians recommend reducing your: salt intake, alcohol & caffeine consumption, and to quit smoking. You should also try and lower your stress levels to a minimum if possible, because stress can also be a major contributor to the cause of an attack.

Meniere's disease is often very frustrating for people who have it. Let your family, friends and co-workers know about the disease and it’s triggers. Tell them how they can help you if you have an attack.