Ménière's disease

Ménière's disease is a long-term inner ear condition causing episodes of vertigo, hearing loss, ringing in the ear (tinnitus), and a sensation of fullness or pressure, thought to result from abnormal fluid build-up in the inner ear. It typically affects one ear, though it can spread to both over time in some people.

The precise cause isn't fully understood, but it's linked to excess fluid pressure within the delicate structures of the inner ear (a condition called endolymphatic hydrops). Factors such as stress, high salt intake, and other health conditions may trigger or worsen episodes in some people.

An attack typically involves sudden, often severe vertigo (a spinning sensation), nausea, and vomiting, alongside muffled hearing, ringing in the ear, and a feeling of pressure or fullness, lasting anywhere from twenty minutes to several hours. Between attacks, most people feel relatively normal, though some residual symptoms can persist.

It's not life-threatening, but the unpredictable, sometimes severe vertigo attacks can significantly affect quality of life and increase the risk of falls or accidents during an episode. Over time, hearing loss can become permanent in the affected ear if not well managed.

There's some evidence suggesting a genetic tendency, as it occasionally runs in families, though most cases occur without a known family history. This remains an area of ongoing research.

There's no cure, but many people successfully manage their symptoms with a combination of dietary changes, lifestyle adjustments, and medication, significantly reducing how often and how severely attacks occur. For a minority with severe, treatment-resistant symptoms, further procedures may be considered.

Treatment usually begins with reducing salt intake and managing stress, alongside medications to reduce fluid retention and control acute vertigo symptoms during attacks. If these measures aren't sufficient, further options including injections into the ear or, rarely, surgery may be discussed with your ENT specialist.

A single attack of vertigo typically lasts between twenty minutes and a few hours, though the associated fatigue and unsteadiness can linger for a day or two afterwards. The overall frequency of attacks varies enormously between individuals, from occasional episodes to several a month.

Ménière's disease causes longer episodes of vertigo lasting minutes to hours, along with hearing loss and tinnitus, while BPPV causes very brief episodes of vertigo triggered specifically by head movement, without hearing changes. This distinction is important because BPPV is treated very differently, often resolving quickly with specific repositioning manoeuvres.

Recurrent unexplained vertigo with hearing changes should be assessed by an ENT specialist to confirm the diagnosis and plan treatment. Private ENT consultations can typically be arranged within about two weeks, considerably faster than standard NHS waiting times.