Imagine feeling as though the room is spinning uncontrollably, your hearing fades in and out, and a persistent ringing, buzzing or roaring sound fills your ears—all without warning. This is the reality for people living with Meniere’s disease, a chronic condition that affects the inner ear that can significantly disrupt daily life. The condition is named after Prosper Meniere, a French physician in the 19th century who discovered the relationship between dizziness and inner ear problems.
What Is Meniere’s Disease?
Meniere’s disease is a disorder of the inner ear that affects balance and hearing. It typically affects only one ear. It is characterized by episodes of severe dizziness – a spinning sensation called vertigo – that lasts between 20 minutes to 12 hours, often accompanied by low to mid frequency hearing loss either before, during or after each episode of vertigo. Common ear symptoms that persist between episodes include ringing (tinnitus), ear fullness and fluctuating hearing loss. Some or all of these symptoms may be present to some degree between episodes. As the disease worsens, each symptom is present to a greater degree as the episodes become more frequently felt.
What Causes Meniere’s?
The exact cause of Meniere’s disease isn’t fully understood, but it’s believed to involve abnormal fluid buildup in the inner ear, known as the endolymphatic system. Several factors may contribute, including:
- Fluid drainage problems
- Viral infections
- Autoimmune responses
- Genetic predisposition
Rather than a single cause, it’s likely a combination of triggers that leads to the condition.
How Is It Diagnosed?
There’s no single test for Meniere’s disease. Doctors usually rely on:
- Medical history and symptom presentation
- Hearing tests (audiometry)
- Balance assessments
- Negative findings on other tests especially of the brain and ears to rule out other causes
Diagnosis is divided into either “Probable” or “Definite” Meniere’s:
Definite:
1. Two or more spontaneous episodes of vertigo lasting 20 minutes to 12 hours
2. Low to medium frequency hearing loss in one or both ears, documented by a hearing test before, during or after one of the episodes.
3. Ear-related symptoms (ear fullness, tinnitus, hearing loss) that occur irregularly.
4. Symptoms are not accounted for by another dizziness or balance related diagnosis.
Probable:
1. This is most likely when you have all of the symptoms listed above except hearing loss confirmed by a hearing test before, during or after an episode of vertigo.
Watch how we use specialized technology to see exactly what the inner ear is doing. This video demonstrates the “invisible” eye movements that help us each a definitive diagnosis.
Meniere’s Disease Treatment and Management
While there’s no cure, many treatments can help manage symptoms and reduce the frequency of episodes:
Lifestyle Changes
- Reducing salt intake to help control fluid retention
- Limiting caffeine and alcohol
- Managing stress
Medications
- Drugs to control vertigo and nausea
- Diuretics to reduce fluid buildup
Therapies and Procedures
- Vestibular Physiotherapy
- Injections into the middle ear
- In severe cases, surgery
Treatment plans are highly individualized, depending on symptom severity and lifestyle.
Can Other Vestibular Conditions Co-Exist With Meniere’s Disease?
What can sometimes complicate diagnosis and management is when a person with Meniere’s develops a different vestibular disorder that results in vertigo as well. For example, our Clinic recently encountered a patient who had long standing Meniere’s but who also developed a sudden onset of vertigo that was positional in behaviour without the associated hearing and ear symptoms. When examined, this patient presented with Benign Paroxysmal Positional Vertigo (BPPV) – severe vertigo when she turned over in bed but without the other ear symptoms. Unlike Meniere’s, BPPV has a cure!
This is a fairly rare occurrence but it highlights the importance of a careful history and assessment and understanding the differential diagnosis of various vestibular disorders. This patient also presented with a very unique nystagmus (eye movements observed with specialized vestibular goggles) when the classic test for BPPV was applied. Fortunately, the BPPV was resolved with 3 positional maneuvers over 2 treatment sessions.
When to Seek Help
If you experience repeated episodes of vertigo, hearing loss, or persistent tinnitus, it’s important to consult a healthcare provider, especially one who specializes in vestibular disorders. Family doctors may or may not be familiar with these conditions. If not, they will likely refer you to a Ear, Nose, Throat (ENT) Specialist. Here at Elevation Physiotherapy, both Alice Chan and Albert Chan have their Advanced Vestibular Physiotherapy Certifications and can both diagnose and treat vestibular conditions. We often co-manage patients with ENTs in Edmonton.
Living with Meniere’s can be challenging. However, by working with your physician, specialist and a vestibular physiotherapist, many people can live full and active lives. The goals of management include reducing the frequency of episodes, reducing symptom intensity and improving your balance, visual and head movements to prevent falls and accidents.
If you or someone you know is struggling with symptoms of dizziness, balance loss, or ear symptoms, don’t ignore these symptoms. Since these conditions are invisible, they are often misunderstood and dismissed. Getting the right support will make a meaningful difference.
At Elevation Physiotherapy, we specialize in Vestibular & Dizziness Rehabilitation, using advanced diagnostics to get to the root of your symptoms. Whether it’s Meniere’s, BPPV, or persistent vertigo, our team is here to help you regain your stability and confidence.