Meniere's Disease: What It Is, Causes, Symptoms, and Treatment

Meniere's disease is a condition characterized by vertigo (dizziness), tinnitus (ringing in the ears), and progressive hearing loss.

Meniere's disease is a condition characterized by vertigo (dizziness), tinnitus (ringing in the ears), and progressive hearing loss. Although there is no definitive cure for this condition, the symptoms can be controlled with various treatments.

What is Meniere's Disease?

Meniere's disease is a significant disorder that affects the inner ear. The inner ear in the human body houses structures responsible for hearing and balance functions. When this condition occurs, it results in vertigo (dizziness), which is felt as a spinning sensation. Depending on the degree of involvement of the inner ear during the course of the disease, problems such as hearing issues and tinnitus may also arise. Meniere's disease typically affects one ear in individuals.

What are the Causes of Meniere's Disease?

The incidence of Meniere's disease varies between 3 and 500 cases per 100,000 people. The most commonly diagnosed group consists of elderly and fair-skinned women. The exact cause of Meniere's disease is not yet fully understood. There are various theories, with particular emphasis on genetic and environmental factors.

The onset of Meniere’s disease is associated with abnormal levels of a fluid called endolymph in the inner ear. Factors that play a role in affecting these fluid levels can be summarized as follows:

• Anatomical abnormalities or blockages in the channels, leading to impaired fluid drainage,
• The immune system's abnormal response to certain conditions,
• Viral infections,
• Genetic factors that increase the susceptibility to Meniere's disease.
  It is believed that no single factor causes Meniere’s disease, but rather a combination of various factors.

What are the Symptoms of Meniere’s Disease?

The symptoms of Meniere's disease vary from person to person. Additionally, the symptoms usually appear suddenly. There can also be differences in the frequency and duration of these symptoms. The medical community refers to the sudden onset of symptoms as an attack. Classic symptoms include a feeling of fullness in the ear, fluctuating hearing loss, and dizziness, and the duration of these attacks can vary from 20 minutes to 24 hours, depending on the person. The main symptoms that can occur during an attack are:

Vertigo
Severe dizziness, known as vertigo, is one of the most noticeable symptoms of Meniere's disease. The symptoms that can occur with vertigo are summarized as follows:

• The person continues to perceive the surroundings as if they are spinning, even while standing still,
• Nausea, vomiting.
  It is very difficult for people with Meniere's disease to predict when a vertigo attack will occur. Therefore, it is crucial for individuals suffering from this disorder to always have their vertigo medication nearby. Symptoms of vertigo can also appear during activities such as driving, operating heavy machinery, climbing stairs, or swimming, so care should be taken.

Tinnitus
Persistent ringing in the ears is another common symptom in individuals with Meniere's disease. This ringing may be perceived as a hum, whistle, buzz, or hiss. People with Meniere's disease often complain about tinnitus, especially when they are tired or in a quiet environment.

Hearing Loss
The level of hearing loss fluctuates depending on the progression of the disease. Individuals with Meniere's disease may also become more sensitive to loud noises. Over time, most individuals with this condition experience varying degrees of hearing loss, so caution is necessary.

Psychiatric Symptoms such as Anxiety, Stress, and Depression
Psychiatric symptoms are other complaints that can occur during the course of Meniere's disease. These symptoms cannot be predicted in advance and may negatively impact the individual's capacity to work. Especially as hearing loss gradually worsens over time, it can disrupt social interactions, potentially paving the way for mental health issues.

Individuals with Meniere’s disease may experience limited freedom, difficulties in their professional lives, and problems in their relationships with those around them. The occurrence of these issues naturally leads to psychological problems such as anxiety and depression. Therefore, it is very important for individuals with Meniere’s disease to be aware of their mental health and seek help from specialized doctors if needed.

Stages of Meniere’s Disease
Meniere's disease is mainly studied in two stages. Between these stages, individuals may not experience long-term symptoms. In the early stages of the disease, people may experience sudden, unpredictable vertigo attacks. During these attacks, mild hearing loss may occur, but this symptom returns to normal once the vertigo attack subsides. Individuals may experience uncomfortable symptoms such as a feeling of fullness and pressure in their ears during the attack. Tinnitus is another common early-stage symptom. After a vertigo attack subsides, patients often feel very tired and exhausted. This exhaustion typically leads to a strong need for sleep.

In the later stages of Meniere's disease, the frequency of vertigo attacks gradually decreases, and in some patients, attacks may cease entirely. However, it should be noted that problems related to balance, hearing, and vision will continue. Individuals may particularly complain of intensified symptoms in dark environments. Hearing loss and tinnitus tend to worsen in the later stages of the disease. In some individuals, as the disease progresses, balance loss may become severe enough to cause falls, so caution is advised.

How is Meniere's Disease Diagnosed?

When patients visit healthcare institutions with complaints related to Meniere's disease, doctors initially perform a physical examination and take the patient's medical history. The methods used to diagnose the disorder can be summarized as follows:

• At least two different vertigo attacks lasting a minimum of 20 minutes but no more than 12 hours, recorded by an ENT specialist
• At least three attacks described by the patient, with at least one evaluated
• Caloric tests
• Electrocochleography
• Exclusion of other disorders that may cause the symptoms

Audiometric tests are crucial in the diagnostic approach to Meniere's disease. These tests, also known as hearing tests, help determine the individual's ability to differentiate between various sound frequencies. Meniere's patients often have trouble detecting low-frequency sounds, although some may experience hearing problems in both low and high frequencies.

In addition to audiometric tests, various balance tests can be used in diagnosing Meniere's disease. Videonystagmography (VNG) is an important test that evaluates body functions related to balance by examining eye movements. Along with VNG, other tests such as rotational chair tests, vestibular-evoked myogenic potential tests, posturography, video head impulse tests, and electrocochleography can also be performed.

How is Meniere's Disease Treated?

Meniere's disease is a chronic (long-term) disorder, and there is currently no definitive cure. However, with various medications, the symptoms of the disease can be managed, and in some severe cases, surgical treatments may be considered.

Frequently Asked Questions About Meniere's Disease

One of the most common questions regarding Meniere's disease is about the medications used for treatment. Medications used to treat conditions like motion sickness and seasickness can help control symptoms like vertigo, nausea, and vomiting associated with Meniere's disease. If nausea and vomiting are intense, antiemetic medications may be prescribed. Diuretic drugs, which are known to reduce fluid buildup, can help prevent the excessive accumulation of endolymph fluid, which plays a significant role in Meniere's disease. In some cases, doctors may inject medication directly into the ear to manage the patient's symptoms. Another frequently asked question is about the dietary plan for Meniere's patients. Limiting foods and substances such as salt, chocolate, and monosodium glutamate in the diet may be effective in alleviating symptoms.