Meniere’s Disease, named after a French physician called Prosper Ménière, is a disorder
of the inner ear that affects both hearing and balance, and is characterised by episodes
of severe dizziness, hearing loss, and tinnitus. It is not known what causes it.
The condition affects about 2 people in every 1000, and tends to affect women more
often than men. Typically, it occurs in adults, with prevalence increasing with age.
Not all sufferers of Meniere’s Disease experience the same symptoms, or the same
severity of symptoms. However, the classic characteristics of the disease are
Attacks of rotational vertigo (dizziness) that are usually severe, incapacitating,
and completely unpredictable. They can last from minutes to hours, or even days and
weeks in some cases. There is often an increase in tinnitus, and temporary loss of
hearing. Hearing may improve after an attack, but nevertheless becomes progressively
worse. Nausea, vomiting, and sweating often accompany vertigo, but these are actually
symptoms of vertigo, not Meniere’s Disease. My worst attack lasted over 18 hours
– 18 hours of lying absolutely still, head spinning, frequently being sick into a
Fluctuating, progressive hearing loss in one or both ears. It usually affects lower
frequencies. Sounds can appear tinny and distorted, and sufferers can experience
sensitivity to loud noise
Unilateral or bilateral tinnitus
A sensation of pressure or fullness in the ears
Periods of remission between attacks are common, and attacks tend to occur in clusters.
I have had occasions when attacks have occurred two or three times a week, and yet
I have experienced periods of remission between clusters lasting for months, and
even for a few years. Unfortunately, the length of remission is no guarantee that
fresh attacks cannot occur without warning.
Meniere’s Disease is linked to an excess of fluid in the inner ear. The inner ear
has a system of membranes containing a fluid called endolymph. In a Meniere’s Disease
attack endolymph bursts from its normal channels and flows into other areas, causing
damage to hearing and balance cells.
There is no cure for Meniere’s Disease. There are few treatments beyond rather severe
surgical processes, so management of the disease tends to be important for sufferers.
It is believed that a high salt diet causes fluid retention within the inner ear,
so sufferers are normally recommended to reduce their salt intake. I actually try
to avoid foods which contain a higher sodium content than 0.2mg per 100 grams of
food. Other substances that sufferers are advised to avoid include caffeine, alcohol,
There are some surgical treatments that can be carried out if Meniere’s Disease -
dizziness, in particular - becomes too difficult to manage, but many such treatments
are destructive, and do not guarantee to preserve remaining hearing. Surgery to decompress
the endolymphatic sac can be temporarily effective. Non-destructive treatments do
not address the root cause of vertigo in Meniere’s Disease, and repeated treatments,
if successful at all, are often necessary. Destructive surgery techniques are irreversible,
and involve the removal of inner ear function. This is called labyrinthectomy. Another
drastic method involves cutting the nerve to the balance part of the inner ear. A
technique called Intra-Tympanic Gentamycin (ITG) is often used in what is called
a chemical labyrinthectomy. ITG treatment involves the injection of a drug called
gentamycin directly into the inner ear, through the ear drum. ITG treatment does
not prevent further attacks, of course. All it does is to destroy the response of
the balance function to the effects of the attack. Decline in hearing, as a result
of an attack, continues. I had right ear ITG in 2001.
Meniere’s Disease usually starts in one ear, and, in about half of all patients,
extends to the other ear over time. One consultant half-jokingly suggested to me
that this is because most people get Meniere’s Disease in middle age, and are dead
before the other ear can be affected. In my case, I contracted Meniere’s Disease
when I was 21, so it was probably always likely that my second ear would be affected.
Hearing loss usually fluctuates in the early years, and becomes permanent in the
later stages, often with severe distortion and fragmentation. Hearing aids and cochlear
implants can be of some use, but Meniere’s damaged hearing is notoriously difficult
to work with. Meniere’s Disease is reckoned to burn out when vestibular function
has been destroyed by the disease to the point where vertigo attacks cease - that
is, when the ear can no longer respond to attacks. I’ve had it now for almost fifty