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Meniere’s Disease Treatments

Rebecca G. Miller by Rebecca G. Miller
March 4, 2023
in Health
0

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, minimizing 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.

Meniere's

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Doctors administer hearing checks, assess balance, and prescribe an internal ear MRI scan to diagnose. They also rule out any disorders, such as a brain tumor 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 percent of people diagnosed with it get headaches or migraines. 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. Doctors may recommend a low-salt diet to avoid potential vertigo — about 1.5 grams of sodium a day (roughly a quarter of a teaspoon)—and add a diuretic medication hydrochlorothiazide-triamterene (Dyazide). The mixture reduces fluid in the ear, minimizing vertigo episodes that 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 the Epley maneuver 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 can increase hearing or treat dizziness for a few months in extreme cases, either by mouth or injection into the middle ear.

If the dizzy spells arise without warning or cause a fall, doctors can prescribe a low dose of gentamicin, an antibiotic given through the eardrum by injection. It is a significant advance in treating 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 extreme vertigo patients. 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.

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