So, what is Ménière’s disease?
January 18, 2022
Ménière’s disease is a relatively rare, chronic, and incurable inner ear disorder. The condition produces recurring symptoms that are thought to result from large amounts of a fluid within the inner ear—a condition known as endolymphatic hydrops. In 1861, the French physician, Prosper Ménière, while researching audio/vestibular afflictions, wrote a pioneering paper that would change how people thought of the condition. Ménière theorized that the characteristic attacks of vertigo, ringing in the ear (tinnitus), and hearing loss seen together in some patients originated within the inner ear, not the brain, as physicians originally thought.
Who gets the condition?
While Ménière’s disease can develop at any age, it is more likely to happen to adults between 40 and 60 years of age. The National Institutes of Health estimates that about 615,000 people in the U.S. have Ménière’s disease and that 45,500 new cases occur each year, which makes it a relatively rare condition relative to other diseases. However, because no official reporting system exists, the actual number of cases is unknown. It is said that about 7-10% of those affected have a family history of the condition.
What causes Ménière’s ?
Ménière’s disease can result from a variety of conditions: circulation problems, viral infection, allergies, an autoimmune reaction, migraine, and genetics—or a combination of these. People with the disorder often claim that certain situations trigger attacks: stress, overwork, fatigue, emotional distress, additional illnesses, pressure changes, certain foods, and too much dietary sodium.
How is it diagnosed?
In 2015, the Bárány Society established specific criteria1 that must be met for the diagnosis of Ménière’s disease:
- Two or more spontaneous episodes of vertigo, each lasting 20 minutes to 12 hours.
- Audiometrically documented low- to medium-frequency sensorineural hearing loss in one ear, defining the affected ear on at least one occasion before, during, or after one of the episodes of vertigo.
- Fluctuating aural symptoms (hearing loss, tinnitus or fullness) in the affected ear.
- Not better accounted for by another vestibular diagnosis.
1 Lopez-Escamez JA, Carey J, Chung W-H, et al. Diagnostic criteria for Ménière’s disease. Journal of Vestibular Research. 2015;25(1):1-7. doi:10.3233/VES-150549.
Ménière’s disease presents with individualized patterns, meaning symptoms before, during, and after an attack will vary from person to person.
In the beginning, someone may experience fluctuating hearing loss, usually in one ear, then progress to attacks of vertigo and dizziness. After an attack, a person may experience extreme fatigue or exhaustion and need hours of sleep.
As the disease progresses, hearing loss tends to become more significant and, for those with unilateral hearing loss, the condition may spread to the second ear. Tinnitus and/or aural fullness may be stronger, though vertigo attacks may lessen. Individual symptoms vary widely.
How long do episodes last?
Attacks can last from 20 minutes to 24 hours. They can occur with the frequency of many attacks each week or they can be separated by weeks, months, and even years. The unpredictable nature of this disease makes managing it challenging. It also complicates the ability of scientists and physicians to study it.
What about a cure?
To “cure” disease means to eliminate the root cause and reverse the damage it has caused. For now, no cure exists, only medical treatments to help manage the symptoms. Today, in the rapidly expanding knowledge of AI, those of us who experience symptoms on a regular basis hold out hope that a safe, permanent cure is not far away.
