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Meniere’s disease is a disorder of the inner ear which causes episodes of vertigo, ringing in the ears (tinnitus), a feeling of fullness or pressure in the ear, and fluctuating hearing loss. The area of the ear affected is the entire labyrinth, which includes both the semicircular canals and the cochlea.
A typical attack of Meniere’s disease is preceded by fullness in one ear. Hearing fluctuation or changes in tinnitus may also precede an attack. A Meniere’s episode generally involves severe vertigo (spinning), imbalance, nausea and vomiting. The average attack lasts two to four hours. Following a severe attack, most people find that they are exhausted and must sleep for several hours. There is a large amount of variability in the duration of symptoms. Some people experience brief “shocks”, and others have constant unsteadiness. High sensitivity to visual stimuli (visual dependence) is common. During the attack the eyes jump (this is called “nystagmus”).A particularly disabling symptom is a sudden fall. These typically occur without warning. These falls are called “otolithic crisis of Tumarkin”, from the original description of Tumarkin (1936). They are attributed to sudden mechanical deformation of the otolith organs (utricle and saccule), causing a sudden activation of vestibular reflexes. Patients suddenly feel that they are tilted or falling (although they may be straight), and bring about much of the rapid repositioning themselves. This is a very disabling symptom as it occurs without warning and can result in severe injury. Often destructive treatment (e.g. labyrinthectomy or vestibular nerve section) is the only way to manage this problem. Other otologic conditions also occasionally are associated with Tumarkin type falls (Black et al, 1982; Ishiyama et al, 2003). See here for more information about drop attacks.Meniere’s episodes may occur in clusters; that is, several attacks may occur within a short period of time. However, years may pass between episodes. Between the acute attacks, most people are free of symptoms or note mild imbalance andtinnitus.Meniere’s affects roughly 0.2% of the population (click here for more details about the epidemiology). Meniere’s disease usually starts confined to one ear but it often extends to involve both ears over time so that after 30 years, 50% of patients with Meniere’s have bilateral disease .
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