What happens in the inner ear
The inner ear contains a system of channels filled with fluid: one part is responsible for hearing, the other for balance. With Meniere's disease, the volume of fluid in these cavities periodically increases, the pressure rises, and the thin septa become overstretched. This disrupts the functioning of sensitive cells and causes an attack: the world begins to spin, noise appears, and hearing decreases. Then the pressure decreases and the condition is restored, but each episode leaves a mark, so over time the hearing deteriorates persistently, and the noise becomes constant.
- Excessive fluid accumulation in the inner ear
- Increased pressure in the labyrinth
- Disruption of hearing and balance cells
- Reversible changes at the onset of the disease
- Gradual persistent hearing loss
How does an attack proceed?
Often an attack is preceded by warning signs: congestion and fullness in the ear, increased noise, a feeling of muffled sounds. Then suddenly severe rotational dizziness occurs, during which it is impossible to stand and walk, nausea, vomiting, sweating, and pallor are added. Consciousness is preserved, there is no weakness in the limbs or speech impairment - this is how an attack differs from a stroke. Duration usually ranges from twenty minutes to several hours. After the attack, weakness, instability and drowsiness remain, which disappear within a day or two.
- Precursors: distension and noise in the ear
- Sudden rotational vertigo
- Nausea and vomiting, sweating
- Hearing loss during an attack
- Duration from 20 minutes to several hours
- Frailty and instability after an attack
Diagnostics
The diagnosis is clinical and is made by the characteristic combination of attacks of dizziness, noise, congestion, and documented hearing loss at low frequencies. Therefore, the key test is a hearing test, preferably repeated, including soon after the attack. Vestibular tests are performed to assess balance function. Magnetic resonance imaging is needed not to confirm Meniere's disease, but to exclude other causes - tumors of the auditory nerve, multiple sclerosis, vascular disorders. The doctor also rules out vestibular migraine, which is very similar in symptoms.
- Examination by an ENT doctor and collection of descriptions of attacks
- Dynamic hearing test
- Tympanometry
- Vestibular tests
- MRI of the brain and inner ear
- Consultation with a neurologist to rule out other causes
Treatment and prevention of attacks
During an attack, it is important to lie down, fix your gaze on a fixed point and not try to walk, so as not to fall; Your doctor may prescribe medications to reduce nausea and dizziness for a short period of time. The main treatment is aimed at prevention: limiting salt, avoiding caffeine, alcohol and nicotine, regular sleep and reducing stress levels, evenly distributing fluids throughout the day. The doctor selects medications for long-term use. For frequent severe attacks that cannot be treated, drugs are administered into the tympanic cavity and surgical methods are used. Vestibular rehabilitation is useful - special exercises that speed up adaptation.
- During an attack, lie down and do not move your head
- Limiting salt in the diet
- Quitting caffeine, alcohol and smoking
- Regular sleep schedule, stress management
- Preparations for prevention as prescribed by a doctor
- Administration of drugs into the tympanic cavity in severe forms
- Vestibular rehabilitation between attacks
- Hearing aid for persistent hearing loss
Living with illness
The main difficulty is the unpredictability of attacks, so it is important to think about safety. You should not engage in activities where sudden dizziness is dangerous: working at heights, near moving machinery, scuba diving. The issue of driving a car is discussed with the doctor individually. It is useful to keep a diary of attacks indicating food, sleep and stressful events: it helps to identify personal provocateurs. Over time, in many patients, attacks become less frequent, and hearing loss and noise come to the fore, which are corrected with a hearing aid and special techniques.
- Diary of attacks and provoking factors
- Refusal to work at heights and near machinery
- Discussing driving with a doctor
- Caution when swimming and in water
- Regular hearing testing
- Support for seizure-related anxiety
