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Lynn S. Alvord PhD
Meniere’s syndrome is a relatively rare disorder when compared with other inner ear disorders causing vertigo. It is still an overused diagnosis.
Meniere’s syndrome currently is defined as vertigo spells lasting 20 minutes to 24 hours, along with temporarily worsened hearing, usually just on one side, of the sensorineural type. Other symptoms that may accompany the above features, but that are not necessary for the diagnosis, are fullness in the ear and tinnitus (ringing or buzzing) which are worse during the episode of vertigo. Vertigo is absent between these episodes.
The cause of the vertigo is generally thought to be a build-up of fluid around nerve areas deep within the inner ear; however, lately some researchers argue that the fluid build-up is an effect rather than cause of the disorder. In other words, there may be some other main “irritative” cause of Meniere’s than fluid build-up.
Perhaps the most dramatic change lately in Meniere’s syndrome management involves newer ways of treating the disorder, often “in office”. This means that the horror stories dominating internet searches of Meniere’s are misleading. See the “Additional information” section on Meniere’s disease. Figure. The definition stated above (being the recent thinking, 2014) has changed throughout the years. The exact criteria have been altered back and forth. I personally feel that there are major pieces of the puzzle missing about Meniere’s disease regarding its cause. I do believe that the current criteria defining Meniere’s are closer to the truth than any criteria previously. Meniere’s over the years has been used as a “garbage can” diagnosis, being greatly overused. Practically anyone with ringing in the ears, dizziness and hearing loss of any type, has been labeled with having Meniere’s disease. With hearing loss and tinnitus (ringing in the ears) being so common, this has resulted in practically anyone having vertigo episodes being assigned the diagnosis of Meniere’s disease. This problem is partly due to the difficulty in testing patient’s hearing “before” and “after” the episode, as fluctuation of hearing is a necessary criterion in the diagnosis. The overuse of the Meniere’s diagnosis is unfortunate because this results in treatments being used that are not appropriate to the patient’s disorder.
The therapy for Meniere’s disease has been modified greatly for the better over the years. An ear, nose and throat doctor (otolaryngologist) or audiologist is usually better equipped to test for Meniere’s disease than most other specialists. Treatment consists of things like modifying the patient’s diet to include low salt and low caffeine or alcohol, as well as sometimes a diuretic (water pill) to reduce fluid build-up. Because there seem to be other factors causing Meniere’s such as allergic factors, hormonal factors (many more female contract Meniere’s disease than males), stress also contributing, the therapies for Meniere’s disease are varied. There are far fewer cases requiring surgery with more simple in-office treatments dominating the current therapies. Again, see your local ear, nose and throat physician for the latest in diagnosis and therapy for Meniere’s disease.