Spinning out of control: Treating Meniere's disease

By BARBARA BEAN-MELLINGER

Feeling Fit Correspondent

Nearly everyone has experienced dizziness, ringing in the ears and the feeling of pressure in the ears that can affect hearing. When the symptoms occur together, however, are severe and accompanied by nausea and vomiting, the cause could be Meniere's disease.

The French physician, Prosper Meniere, recognized in 1861 that some people suffered from attacks that included many of these symptoms together, and named the affliction Meniere's disease.

According to the U.S. National Library of Medicine, most attacks affect just one ear, and start with a feeling of fullness or pressure in that ear. Ringing or "roaring" in the ear and some degree of hearing loss also accompany the pressure, and dizziness that can be mild or severe. For some people the symptoms are mild or the attacks occur infrequently. For others, the attacks are severe and debilitating and can include nausea and vomiting. Some attacks last two to four hours or more, and leave the sufferer exhausted afterward.

Dr. Olewale Idewu is a Punta Gorda ear, nose and throat specialist who treats patients with Meniere's disease. He explained that the dizziness that is indicative of Meniere's disease is a spinning sensation, a feeling as if the room is spinning.

"It is different from the feeling of light-headedness, and some people have difficulty distinguishing between the two," said Idewu. "However, nausea and vomiting usually accompany the symptoms, and sometimes a ringing in the ears. The hearing loss is usually the last symptom, and it can be intermittent at first."

Although Idewu agreed that Meniere's disease usually affects just one ear, it can affect both, he said. Symptoms most often occur after age 40 and are more common in women.

The cause of Meniere's disease is not known, and it may have multiple triggers. According to an article on Mayoclinic.com, factors that change the composition and level of inner ear fluid may cause the symptoms. Many factors are suspected, including an anatomical abnormality that prevents fluid from draining properly, allergies, viral infections, head trauma, an abnormal immune response and genetic predisposition.

Diagnosing Meniere's disease involves first assessing the accumulation of symptoms and how often they occur. Several tests also help in the diagnosis. The most common test is electronystagmography, which measures eye movements in response to warm and cold water or air that is put into the ear canal.

Additional tests are sometimes used to rule out other illnesses. Magnetic resonance imaging (MRI), computer tomography (CT) and auditory brainstem response audiometry can help detect tumors or multiple sclerosis, both of which can cause similar symptoms.

Unfortunately, there is no cure for Meniere's disease, but most people are able to manage their symptoms with medications to treat motion sickness, nausea and to reduce fluid retention.

Rehabilitation exercises can help the body and brain regain communication that improves balance. A device called a Meniett pulse generator can be used at home to apply pressure to the middle ear to restore correct fluid levels.

Injections to the middle ear, given under local anesthesia in a doctor's office, can help control and reduce the number of attacks of vertigo, the spinning sensation that occurs with Meniere's disease.

Several different types of surgery are used as a last resort for symptoms that are debilitating and don't respond to other methods.

Idewu practices at 103 W. Marion Ave., Punta Gorda. Call 941-205-5555 for more information or to make an appointment.

For more information on Meniere's disease go to www.mayoclinic.com/health/ menieres-disease/DS00535/METHOD=print&DSECTION=all or www.ncbi.nlm.nih.gov/ pubmedhealth/PMH0001721/.