Meniere's Disease

Ménière's disease is a chronic inner-ear disorder that causes episodes of severe vertigo + tinnitus + fluctuating hearing loss + a sensation of fullness in one ear. It is often under-diagnosed in India — the episodes can be mistaken for "weakness" or BP fluctuations.

Classic attack

• Sudden severe spinning vertigo lasting 20 minutes to several hours.
• Ringing/roaring tinnitus in one ear.
• Muffled/fluctuating hearing loss in the same ear.
• Ear fullness or pressure.
• Often associated nausea and vomiting.
• Attacks come in clusters, with variable gaps of days to months between.

Diagnosis

• Clinical — pattern of attacks plus audiometry showing low-frequency sensorineural hearing loss.
• MRI to rule out other causes of vertigo with hearing loss.
• Diagnosed by an ENT / neuro-otologist.

Management

• Low-salt diet — the cornerstone; aim under 2–3 g/day. Especially relevant in India given high dietary salt.
• Avoid caffeine, alcohol, and monosodium glutamate; reduce stress.
• Diuretic tablets to reduce inner-ear fluid (prescription).
• Betahistine (a common prescription in India) for prevention.
• Acute attack: lie still, antiemetic + vestibular sedative for 24–48 hours; most attacks self-limit.
• Vestibular rehabilitation helps residual imbalance between attacks.
• For severe, uncontrolled disease: intratympanic steroid injections, or in a small minority, chemical or surgical labyrinthectomy — at specialist centres.
• Hearing aid as hearing loss progresses.

Safety points

• Don't drive during or for hours after an attack.
• Tell your employer — roof-work, scaffolding, and driving may need adjustment.
• Fall-proof the home — grab bars, night lights.
• Carry a medical note listing the condition and current medicines in case an attack happens in public.