Ménière's Disease

Ménière's disease is a chronic inner ear condition causing episodes of vertigo, hearing loss, tinnitus, and a feeling of fullness in the ear, thought to result from abnormal fluid build-up within the inner ear. Episodes can be unpredictable and vary significantly in frequency and severity between individuals.

The exact cause isn't fully understood, but it's associated with excess fluid pressure within the inner ear (endolymphatic hydrops), possibly triggered or worsened by factors including stress, salt intake, and certain other health conditions. Research into the precise underlying mechanisms continues.

The classic combination includes episodes of vertigo lasting minutes to hours, fluctuating hearing loss, tinnitus (ringing in the ear), and a sensation of pressure or fullness in the affected ear. Symptoms typically affect one ear initially, though both ears can become involved over time in some cases.

It's not life-threatening, but the unpredictable vertigo episodes can significantly affect quality of life and safety, particularly increasing fall risk during attacks, and hearing loss can become permanent over time in the affected ear. Appropriate management can significantly reduce the frequency and severity of episodes for many people.

There's some evidence of a genetic predisposition, as it can occasionally run in families, though most cases occur without a clear known family history. Research continues to explore potential genetic contributing factors.

There's no cure, but various treatments can significantly reduce the frequency and severity of episodes for many people, including dietary and lifestyle measures, medication, and, for severe cases resistant to other treatment, specific procedures. Management is usually individualised based on how well specific measures control your symptoms.

Treatment typically starts with lifestyle measures including reduced salt intake and stress management, alongside medication to reduce fluid retention or manage acute vertigo symptoms. For severe, treatment-resistant cases, options including injections into the ear or surgical procedures may be considered.

Diagnosis is based on the characteristic combination of symptoms occurring together, supported by hearing tests showing fluctuating hearing loss, and sometimes specific balance testing. Other conditions causing similar symptoms need to be excluded as part of the diagnostic process.

Ménière's disease causes recurrent episodes with the characteristic combination of vertigo, fluctuating hearing loss and tinnitus, typically without a preceding infection, while labyrinthitis causes a single episode of severe vertigo, often following a viral infection, with symptoms gradually improving rather than recurring in the same pattern. The recurring, fluctuating nature of Ménière's disease distinguishes it from this and other causes of vertigo.

Recurrent episodes of vertigo with hearing changes should be assessed by an ENT specialist. Private ENT consultations can typically be arranged within about two weeks, considerably faster than standard NHS waiting times.