- Ménière’s disease is a disorder of the inner ear characterised by recurrent episodes of vertigo and ear symptoms.
- In most cases, it affects only one ear. During episodes, it significantly impairs daily functioning, reduces quality of life, and increases the risk of falls and injuries.
- Ménière’s disease usually begins between the ages of 40 and 60 and is slightly more common in women.
- The course of the disease varies: in some individuals, the impact is mild or disappears, while in others, symptoms persist throughout life, significantly affecting their quality of life.
Symptoms of Ménière’s Disease
Typical symptoms include:
- Recurrent vertigo: attacks that begin and end suddenly, lasting 20 minutes to 12 hours. Rarely, attacks may last up to 24 hours. Vertigo is often accompanied by nausea.
- Hearing loss: initially fluctuating in the early stages but often becoming permanent over time, typically causing low-frequency hearing loss.
- Tinnitus: ringing, buzzing, hissing, whistling, or roaring sounds in the ear.
- Aural fullness: a sensation of pressure or congestion in the affected ear.
- Sound sensitivity: hypersensitivity to loud or distorted sounds.
- Increased risk of imbalance and falls: especially during acute episodes.
Diagnostic Criteria
Diagnosis is based on clinical findings and hearing tests. The criteria include:
- Two or more episodes of vertigo lasting 20 minutes to 12 hours.
- Documented hearing loss in one ear (typically at low frequencies).
- Fluctuating ear symptoms (hearing loss, tinnitus, or ear fullness) in the affected ear before, during, or after vertigo episodes.
- Symptoms most consistent with Ménière’s disease.
The diagnosis is considered very likely if all criteria are met, and reasonably likely if criteria 1, 3, and 4 are present.
Causes and underlying factors
The exact cause of Ménière’s disease is unknown. Symptoms are believed to result from excess fluid in the inner ear (endolymphatic hydrops), although the underlying cause of this condition remains unclear. Multiple factors likely play a role, including:
- Impaired fluid drainage due to blockages or anatomical abnormalities
- Autoimmune processes
- Viral infections
- Genetic predisposition
Vestibular Rehabilitation in Ménière’s Disease
Balance depends on coordination between the inner ear (vestibular system), vision, sense of body position (proprioception), and the brain. Ménière’s disease disrupts this system, but vestibular rehabilitation can help retrain it.
Goals of Vestibular Rehabilitation
- Improve balance and stability
- Reduce dizziness and vertigo-related symptoms
- Lower the risk of falls
- Enhance coordination of head and eye movements
- Increase overall confidence and independence in daily activities
Rehabilitation is most effective when based on a thorough examination, allowing exercises to be tailored to each person’s specific balance problems and needs. International guidelines recognise vestibular rehabilitation as an evidence-based treatment for improving both symptoms and quality of life in Ménière’s disease.
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