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Timothy C. Hain, MD • Page last modified: July 29, 2022 Before starting, we are proud to note that this page was ranked as the most reliable web page on Meniere's, by an article in an Otolaryngology journal evaluating 50 web sites on Meniere's disease (Bojrab et al, 2020)). Our score for reliability was 2.96, compared to (for example), Mayo clinic's page which scored 2.63 (which was google ranked #1). Below is a short movie of a Meniere's attack showing the characteristic jumping of the eyes. Patients now sometimes make video's of their eyes using their smart phone and bring in something that looks like this movies\Menieres.mp4" Your browser does not support the video tag.
What is Meniere's disease ?
A particularly disabling symptom is a sudden fall. These typically occur without warning. Here is a link to a Youtube video of one. These falls, a variant of "drop attacks", 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. low dose gentamicin) is the best way to manage this problem (Wu et al, 2019). 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 and tinnitus.
What causes Meniere's Disease? (Click here for a more detailed discussion)
The origin of Meniere's disease is presently controversial. While in the past, it was felt that plumbing problems (hydrops) in the ear were responsible for the disease, the most current opinion is that hydrops is a marker for the Meniere's disease, rather than necessarily being responsible for the symptoms.
Click here for more about the causes of Meniere's disease. What damage is done by Meniere's Disease?
How common is Meniere's disease?
Is there a cure?
How does the doctor know I have Meniere's disease ?
MEDICATIONS FOR AN ACUTE ATTACK OF MENIERE'SThis is the way that we manage acute attacks at Chicago Dizziness and Hearing Medications commonly used for an acute attack include the following:
Additional information about prevention of vomiting is found here. How do I manage an attack?
MEDICATIONS USED BETWEEN ATTACKS (also see flowchart below)Diuretics -- those in common use all tend to be combination of a thiazide (that is potassium decreasing) and a sodium channel blocker (e.g. traimterine or amiloride). The combinations have the advantage that they may not require potassium supplementation.
Vestibular Suppressants (click here for more details on drug treatments)
Calcium Channel Blockers -- these drugs are rarely used as well. They are more commonly used for migraine.
Steroids (commonly for severe bouts) -- commonly used, evidence is not strong for efficacy
Agents that are controversial
What can be done to reduce the frequency and severity of Menieres disease attacks (i.e. prevention) ?This is the way that we attempt to prevent Meniere's attacks at Chicago Dizziness and Hearing: The purpose of treatment between attacks is to prevent or reduce the number of episodes, and to decrease the chances of further hearing loss and damage to the vestibular system. A permanent tinnitus (ringing in the ears), constant imbalance, or a progressive hearing loss may be the consequence of long-term Meniere's disease. Hearing aids may be necessary. Standard medical treatments:
Not so standard treatments
What the author recommends in his practice in Chicago for medical prevention of Meniere's. These drugs are administered to most of his patients, generally in the following sequence:
Treatments for Meniere's that are slightly effective
Last resort treatment regimens
Pregnancy and Menieres
How might Meniere's disease affect my life?
Hydrops Diet (see here for more detail)
More information on Meniere's disease:Self-help groups.
Written By: Timothy C. Hain, MD of Chicago Dizziness and Hearing. Return to IndexReferences: (links are sometimes provided for journals with relatively low SNIP (quality) scores).
Books on Meniere's Disease:
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