Alternate Names: Hydrops; Endolymphatic hydrops

Causes and Risks: The fluid-filled semicircular canals (labyrinth) of the inner ear, along with the 8th cranial nerve, control balance and position sense. Meniere’s disease involves a swelling of the part of the canal (endolymphatic sac) that controls the filtration and excretion of the fluid of the semicircular canal.

The exact cause of Meniere’s disease is unknown. It may be related to middle ear infection (otitis media), syphilis, or head injury. Other risk factors include recent viral illness, respiratory infection, stress, fatigue, use of prescription or nonprescription drugs including aspirin, and a history of allergies, smoking, and alcohol use.

Prevention: Prompt treatment of ear infection and other related disorders may help prevent Meniere’s.

Symptoms:

• Abnormal sensation of movement of self or the environment (vertigo)
  • May be episodic
  • Lasting from minutes to more than 8 hours
  • Worse with sudden movement
• Dizziness
• Hearing loss in one ear
  • Low frequency noises lost first
  • Extent of hearing loss may change
• Noises or ringing in one ear (tinnitus)
• Nausea, vomiting
• Sweating, may be profuse
• Eye movements, uncontrollable

Signs and Tests: A neurologic examination may show an abnormality of cranial nerve VIII.

Tests to distinguish Meniere’s disease from other causes of vertigo may include:

• Head CT scan or head MRI scan
• Caloric stimulation (tests reflexes of the eyes) -- abnormal results indicate Meniere’s disease
• EEG, evoked potential studies
• Electronystagmography
• Audiology/audiometry

Treatment: There is no known cure for Meniere’s disease. Treatment is focused on relieving symptoms by lowering the pressure within the endolymphatic sac.

Antihistamines, anticholinergics, sedative-hypnotics, anti-emetics, diazepam, and other medications may relieve dizziness, vertigo, and associated nausea and vomiting. Diuretics may lower endolymphatic pressure.

Diet recommendations include a low-salt diet to reduce fluid retention (see sodium in diet).

Surgery on the labyrinth, endolymphatic sac, or the vestibular nerve may be required if symptoms are severe and do not respond to other treatment.

Avoid sudden movements that may aggravate symptoms. Help may be needed with walking due to loss of balance. Rest during severe episodes, and gradually increase activity. Avoid hazardous activities such as driving, operating heavy machinery, climbing, and similar activities until one week after symptoms disappear. During episodes, avoid bright lights, TV, or reading, which may make symptoms worse.

Prognosis: The outcome varies. Meniere’s disease can often be controlled with treatment. Recovery may occur spontaneously. However, the disorder may be chronic or disabling.

Complications:

• Inability to walk or function due to uncontrollable vertigo
• Hearing loss on the affected side

Call for an appointment with your health care provider if symptoms of Meniere’s disease, such as hearing loss, occur or worsen. Also call if new symptoms develop, especially persistent vomiting, a fever over 101 degrees F, convulsions, or fainting.