Meniere’s disease is a disorder of the inner ear. The symptoms of this condition include recurrent episodes of spinning-around dizziness or vertigo, fluctuating hearing loss, tinnitus (noise in the ear, often likened to listening to a conch sea shell), and sensations of ear fullness and/or pressure. Often, Meniere’s spells are unpredictable.
The exact cause of Meniere’s disease is not known. Spells may be due to ischemia (decrease or lack of blood flow) within inner ear tisues.
Meniere’s Disease is thought to be triggered by immune reactions, metabolic disturbances within the inner ear, inner ear infections or trauma, possible allergic conditions, and other injures to the inner ear.
A new theory by Carol Foster, M.D. of the University of Colorad,o is that Meniere’s Disease is caused by ischemia or lack of blood flow to inner ear tissue. Dr. Foster has proposed that increase fluid pressure within the cochlea (endolymphatic hydrops) causes a decrease in blood flow to cochlear and vestibular tissues. Her theory is compatible with the clinical presentation of Meniere’s Disease. However, we do not know what causes the increase in fluid pressure within the cochlea (increased production of inner ear fluid, decreased reabsorption of the fluid, or a combination of both).
Classically, Meniere’s disease begins in one ear at around age 50. In 30-50% of patients, it may eventually involve both ears. There is no physical pain associated with Meniere’s Disease. However, there is considerable emotional pain when the disease is difficult to control, and the spells are unpredictable.
Rarely, Meniere’s Disease is genetic. It may be expressed in multiple family members such as brothers and sisters. The genetics of Meniere’s Disease is not well understood at this time. Genetic studies are being performed at The University of Iowa, Iowa City, IA as well as several other leading research centers.
Vertigo (Rotational Spinning)
The disease is characterized by sudden, often unpredictable, spells of rotational dizziness called “vertigo” that is usually the most bothersome symptom along with hearing loss. Episodes of true vertigo classically last from 20 minutes to 24 hours, occur unpredictably, and are usually accompanied by nausea, vomiting, intense sweating, inability to walk, and general incapacitation.
Hearing loss is generally most pronounced in the lower frequencies and is accompanied by a distinct sensation of pressure, fullness or a stopped-up feeling in the ear. Initially, hearing levels may fluctuate and then return almost to normal. However, as the disease becomes more advanced, hearing levels may remain permanently and severely impaired. Hearing loss may effect one or both ears. Typically, one ear will lose hearing and then the other ear will begin to lose hearing months or years later. Again, the hearing loss may be due to patchy areas of ischemic tissue within the inner ear secondary to a lack of adequate blood flow.
Tinnitus (Ear Noises)
Sea shell-like roaring, ringing or bell-like noises in the ear (tinnitus) can be extremely distracting and bothersome. Tinnitus tends to worsen during the acute episodes of vertigo and then subside. It may never quite disappear even after the acute spell is over. Other symptoms may include:
- a feeling of constant fullness in or around the ear
- a sensation of distortion of sounds even when hearing levels are not impaired
- an increased sensitivity to loud sounds
- drop attacks without loss of consciousness (Falling Spells of Tumarkin)