Meniere’s Disease

We don’t know the cause of Meniere’s disease, but doctors believe symptoms of Meniere’s disease are due to an abnormal amount of fluid in the inner ear. Why this happens is not clear. Some possibilities that influence this imbalance in fluid, however, could be: 

• Improper fluid drainage that arise from an anatomic abnormality 
• An autoimmune disease 
• Viral infection 
• Genetics 
• Head trauma
• Migraines 

It is likely that Meniere’s disease comes from a combination of factors. 

Meniere’s disease is not an “ongoing” disease that affects patients throughout the day; rather, symptoms tend to come swiftly as “attacks”. These symptoms include: 

• A spinning sensation, otherwise known as vertigo. These vertigo attacks can come very suddenly and last anywhere from a few minutes to 24 hours 
• Temporary loss of hearing in the affected ear
• Roaring ringing sound in the affected ear (tinnitus) 
• Feeling of fullness in the affected ear 
• Loss of balance 
• Headaches, nausea, vomiting and cold sweats induced by severe vertigo 

In a Meniere’s disease attack or episode, you will experience at least two or three of the above symptoms at one time. But as mentioned, these episodes are not ongoing and patients do not experience symptoms in between attacks. In the event that these symptoms occur during a period of no attacks, there might be a possibility that the symptoms are caused by other problems in the ear.

Dr Dennis Chua will conduct tests to examine your balance and hearing, including: 

Hearing test (audiometry)

A hearing test, or audiometry, is used to check if you have hearing loss. You will be required to put on headphones and listen to noises across a variety of pitches and volumes. You then have to indicate to the technician whether you can or cannot hear a tone. You will also be tested on whether you can differentiate between similar sounds — so in this test, you’ll hear words through headphones and repeat what you hear. This helps Dr Chua determine if you have a hearing problem in one or both ears. People with Meniere’s disease usually have problems hearing low frequencies. 

Dr Chua will also do an electrocochleography test to measure electrical activity in your inner ear, as well as an auditory brainstem response to check if your hearing nerves in your brain are functioning. These tests will help determine if your hearing loss is due to a problem with your inner ear or ear nerve. 

Balance test 

Balance tests, a common one being electronystagmography (ENG), are performed to test the function of your inner ear. In this test, hot and cold water is pushed into your ear as water causes your balance function to work. Electrodes are placed around your eyes to detect involuntary eye movements. Any abnormalities could signal a problem with the inner ear. 

There is no cure for Meniere’s disease, but symptoms can be eased through motion sickness medication to ease symptoms of vertigo, nausea and vomiting. A diuretic may also be prescribed to reduce the amount of fluid in your body, since Meniere’s disease is thought to be caused by a problem with fluid in the inner ear. 

Physical therapy is also an option to improve symptoms of vertigo and condition your brain to get used to the imbalance between your two ears. 

In some cases, a hearing aid or the Meniett device, a device that delivers pulses of pressure to the inner ear, may be necessary.