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Meniere's Disease

Meniere's disease is an inner-ear disorder causing episodes of spinning vertigo, fluctuating hearing loss, tinnitus, and ear fullness. Diet changes and medication control attacks for most people.

ENT
Meniere's disease is a disorder of the inner ear that causes repeated episodes of spinning dizziness along with hearing symptoms, usually in one ear. It most often begins between ages 40 and 60. Attacks are unpredictable, which makes the condition frightening — but with diet changes and medication, most people gain good control of their symptoms. Causes: Meniere's disease is linked to an excess buildup of fluid (endolymph) in the inner ear. The extra fluid distends the delicate membranes of the hearing and balance organs, disrupting the signals they send to the brain. Why the fluid accumulates is not fully understood, but factors thought to contribute include:
  • Impaired fluid drainage: A blockage or anatomic variation in the inner ear's drainage system.
  • Immune and viral factors: An abnormal immune response or prior viral infection of the inner ear may play a role.
  • Genetics: The condition sometimes runs in families.
Symptoms: A classic attack combines four features:
  • Episodes of vertigo: A spinning sensation lasting from about 20 minutes up to 12 hours, often with nausea and vomiting. Some people notice a warning of fullness or louder ringing in the ear minutes before the spinning begins. Learn more about vertigo and its causes.
  • Fluctuating hearing loss: Hearing — especially for low-pitched sounds — worsens around attacks and may recover early on, but can become permanent over years.
  • Tinnitus: Roaring, buzzing, or ringing in the affected ear; see our page on tinnitus.
  • Aural fullness: A sensation of pressure or blockage in the ear, often building before an attack.
Diagnosis: There is no single test for Meniere's disease. The diagnosis rests on the pattern of repeated vertigo episodes plus documented hearing changes. Your physician will take a careful history, arrange a hearing test — which typically shows low-frequency hearing loss in one ear — and may order balance testing. An MRI is often obtained to rule out other causes such as an acoustic neuroma, and the history helps distinguish Meniere's from vestibular migraine, which can look similar. Between attacks the examination may be entirely normal, so a clear description of your episodes is the most valuable information you can bring to the visit. Treatment: Treatment aims to relieve attacks and reduce how often they occur:
  • During an attack: Vestibular suppressants such as meclizine and anti-nausea medications such as promethazine ease vertigo and vomiting. Sit or lie still, and do not drive until the episode fully passes.
  • Prevention: A consistent low-salt diet is the cornerstone; limiting caffeine and alcohol also helps many patients. A diuretic (water pill) is often added to reduce inner-ear fluid pressure, and keeping salt intake steady through the day matters as much as keeping it low.
  • Vestibular rehabilitation: Balance-retraining exercises improve steadiness between attacks.
  • Procedures for refractory cases: When attacks persist despite medical therapy, ear specialists can offer injections into the middle ear or, rarely, surgery.
  • Hearing support: A hearing aid helps when hearing loss becomes fixed.
When to Seek Immediate Care: A first episode of severe dizziness deserves prompt medical evaluation — and if dizziness comes with weakness, slurred speech, double vision, trouble walking, or a severe headache, call 911, because these can signal a stroke rather than an inner-ear problem. Living with an unpredictable condition is easier with a consistent medical partner. The internal-medicine team at Zimmer Medical Group can coordinate your diagnosis, diet plan, and specialist care — schedule an appointment to get started.

Related Medications

Commonly prescribed medications for this condition

Promethazine

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