There is no cure for Meniere’s disease. Still, lifestyle changes such as stopping smoking, following a low-salt diet, eliminating monosodium glutamate (MSG), restricting caffeine, doing balancing workouts, minimising stress, and certain medications can alleviate symptoms. They can decrease the number of future attacks.
Experts attribute excessive discharge and swelling of the inner ear to Meniere’s disease. It can also be familial, with multiple mutations raising the risk of the disease occurring. Here’s an insight into some treatments for Meniere’s disease.
Doctors administer hearing checks, assess balance and prescribe an internal ear MRI scan to make a diagnosis. They also rule out any disorders, such as a brain tumour or multiple sclerosis, that may cause hearing loss, tinnitus, ear fullness or vertigo. No specific risk factors have been reported for Meniere’s, but about 50 per cent of people diagnosed with it get headaches of migraine. They are also more likely to develop a form of dizziness called benign positional paroxysmal vertigo (BPPV)-the unexpected spinning feeling or turning inside the head.
Some doctors prescribe migraine prevention medications such as the antiepileptic drug topiramate (Topamax) and the antidepressant nortriptyline (Pamelor), which have been shown to function with a small number of Meniere’s patients, regardless of the overlap in migraine and Meniere’s.
Hearing loss and tinnitus treatments associated with Meniere’s aren’t too effective. When hearing loss develops, as it does very slowly, hearing aids can eventually be beneficial for decades in most cases. If it continues to progress, however, hearing aids are no longer effective. To avoid potential vertigo, doctors may recommend a low-salt diet — about 1.5 grammes of sodium a day (roughly a quarter of a teaspoon)—and add a diuretic medication such as hydrochlorothiazide-triamterene (Dyazide). The mixture reduces the amount of fluid in the ear, which may minimise vertigo episodes which develop progressive hearing loss.
Proof of the efficacy of anti-vertigo medications like betahistine (Serc) is insufficient, but doctors nevertheless recommend them.
Doctors may prescribe something called the Epley manoeuvre for people who have BPPV, an exercise that helps reposition the calcium crystals in the ear that become loose and cause dizziness. Doctors typically prescribe meclizine (Vertical), an antihistamine used for motion sickness, or lorazepam (Ativan), a benzodiazepine and sedative, likely paired with an anti-nausea medication called ondansetron (Zofran), to treat sudden dizzy spells. Steroid treatments, either by mouth or as an injection into the middle ear, can increase hearing or treat dizziness for a few months in extreme cases.
If the dizzy spells arise without warning or cause a fall, doctors can prescribe a low dose of gentamicin, an antibiotic that is given through the eardrum by injection. It is a significant advance in the treatment of harmful dizzy spells, eliminating more drastic measures such as nerve cutting or removing the inner ear surgically. However, because the treatment can damage the vestibular function and exacerbate hearing, it is intended for those with extreme vertigo. Besides medicine, vestibular rehabilitation therapy — exercises that help you change your vision and balance to feel less dizzy and more in control — may help avoid at least certain Meniere’s attacks and make them easier to treat.
