Meniere’s disease

Meniere's disease

Article by S.Armfield, Z. Russell

What is Meniere’s Disease?

Meniere’s disease is a disorder that affects the inner ear. The inner ear contains tubes filled with fluid called “labyrinths.” The inner ear is responsible for your balance, as well as hearing. This disorder causes vertigo (a spinning sensation), hearing problems, and a ringing sound in the ear.

What Causes Meniere’s Disease?

The symptoms of Ménière’s disease are caused by the buildup of fluid in the compartments of the inner ear, called the labyrinth. The labyrinth contains the organs of balance (the semicircular canals and otolithic organs) and hearing (the cochlea). It has two sections: the bony labyrinth and the membranous labyrinth.

Meniere’s Disease Symptoms

Symptoms of Meniere’s Disease include:

  • vertigo (attacks can last anywhere from a few minutes to 24 hours)
  • loss of hearing in the affected ear.
  • tinnitus (a sensation of ringing) in the affected ear.
  • a feeling of fullness in the affected ear.
  • loss of balance.
  • headaches.
  • nausea, vomiting, and sweating caused by severe vertigo.

How is Meniere’s Disease Diagnosed?

A diagnosis of Meniere’s disease requires two episodes of vertigo, each lasting 20 minutes or longer but not longer than 24 hours. Hearing loss is verified by a hearing test: tinnitus or a feeling of fullness in your ear.

Meniere’s Disease Treatment

Motion sickness medications, such as meclizine or diazepam (Valium), may reduce the spinning sensation and help control nausea and vomiting. Anti-nausea medications, such as promethazine, might control nausea and vomiting during an episode of vertigo.

Meniere’s Disease Prognosis

Most people can manage their Meniere’s symptoms with diet and lifestyle modifications and a medical plan prescribed by their doctor.

  • With a thorough evaluation, and if you are motivated, you can often control attacks. Careful follow-ups with your doctor and any ENT specialists are needed regularly to monitor symptoms, progress, and adjust therapy throughout the disease process.
  • Only a minority of people require a surgical procedure to control their attacks. You should consider thorough evaluation by an ear, nose, and throat specialist if medical management fails.
  • If hearing levels decrease over time, You may need amplification of sound or surgical management in extreme cases to improve hearing.

Vertigo & Dizziness

Common Causes

vertigo (1)

Due to the complex diagnostic skills required to diagnose the cause of your vertigo or dizziness accurately, we highly recommend seeking the professional opinion of a healthcare practitioner with a special interest in the assessment and management of vestibular disorders.

Article by Shane Armfield

Common Causes of Vertigo & Dizziness

Dizziness & Vertigo FAQs

Due to the complex diagnostic skills required to diagnose the cause of your vertigo or dizziness accurately, we highly recommend seeking the professional opinion of a healthcare practitioner with a particular interest in assessing and managing vestibular disorders.

Article by John Miller

Are You Suffering Vertigo Or Dizziness?

Vertigo or dizziness are symptoms rather than a disease. Vertigo refers to the sensation of spinning or whirling that occurs due to a disturbance in your balance (vestibular) system.

Vertigo is a type of dizziness that feels as though you or your surroundings are spinning. Vertigo may be used to describe feelings of dizziness, lightheadedness, faintness, and unsteadiness. The sensation of movement is called subjective vertigo, and the perception of motion in surrounding objects is called objective vertigo.

Vertigo usually occurs due to a disorder in the vestibular system (structures of the inner ear, the vestibular nerve, brainstem, and cerebellum).

Your vestibular system is responsible for integrating sensory stimuli and movement and keeping objects in visual focus as the body moves.

When your head moves, signals are transmitted to the labyrinth, an apparatus in the inner ear made up of three semi-circular canals surrounded by fluid. The labyrinth then transmits movement information to the vestibular nerve. The vestibular nerve carries the information to the brainstem and cerebellum (areas of the brain that control balance, posture, and motor coordination).

Dizziness is mainly caused by problems of the inner ear and is treatable. Dizziness may also be caused by other conditions such as low blood pressure, some heart problems, anxiety or low blood sugar.

What Is The Number One Cause Of Vertigo?

The most common cause of vertigo is Benign Paroxysmal Positional Vertigo (BPPV). Fortunately. BPPV is also one of the quickest conditions to resolve using some skilled treatment methods.

What is the fastest way to resolve BPPV?

Other Causes Of Vertigo Besides BPPV

Other causes of vertigo include inflammation in the inner ear (vestibular neuritis), Meniere's disease, neck joint dysfunction (cervicogenic dizziness), vestibular migraine and acoustic neuroma. Rarely, vertigo can be a symptom of a more serious neurological problem such as a stroke or brain haemorrhage. Please seek the professional advice of your trusted healthcare professional.

More Info

BPPV - Benign Paroxysmal Positional Vertigo

Vestibular Physiotherapy

Common Causes of Vertigo & Dizziness

Article by John Miller

BPPV Symptoms

The symptoms of Benign Paroxysmal Positional Vertigo (BPPV) can include:

  • Sudden episodes of violent vertigo.
  • Dizziness and/or nausea.
  • Movements of your head trigger vertigo.
  • Your vertigo may last half a minute or more.
  • Your eyes may drift and flick uncontrollably (nystagmus).

What Causes BPPV?

Inside your inner ear, there is a series of canals filled with fluid. These vestibular canals are at different angles. When your head is moved, the liquid rolling inside these vestibular canals tells the brain exactly how far, how fast and in what direction your head is moving.

BPPV is caused by little 'ear rocks' or otoconia (calcium carbonate crystals) within the vestibular canals.

Usually, these crystals are held in unique reservoirs within other inner ear structures (saccule and utricle). It is thought that injury or degeneration of the utricle may allow the 'ear rocks' to dislodge and escape into the balance organ and interfere with your vestibular system.

What Causes Your 'Ear Rocks' to Dislodge?

Factors that may cause or allow 'ear rocks' to migrate into your vestibular canals include:

  • Head or ear injury.
  • Ear surgery or ear infection, such as otitis media.
  • Degeneration of the inner ear structures.
  • Vestibular neuritis (viral infection of the inner ear).
  • Meniere's disease (a disorder of the inner ear).
  • Some types of minor strokes.

In around half of BPPV cases, you can't find the cause of your BPPV, which is known as idiopathic BPPV.

How is BPPV Diagnosed?

Dizziness and vertigo are common to many medical conditions, so careful differential diagnoses are essential. Your physiotherapist or doctor may use several tests to diagnose BPPV.

What is the Treatment for BPPV?

'Ear Rock' Relocation Techniques

After assessing you and confirming BPPV, your BPPV trained physiotherapist will apply specific techniques to relocate the "ear rocks" to an area in the inner ear that doesn't stimulate your feelings of dizziness or vertigo.

How Successful is BPPV Treatment?

When performed correctly, BPPV techniques immediately reduce your vertigo, dizziness, and other symptoms of BPPV is immediate in 80% or more cases. Quality BPPV practitioners have a 90%+ success rate within three applications of the techniques.

Other BPPV Treatment Options?

Due to the physical presence of ear rocks within your vestibular canal, only the relocation of these ear rocks will clear your BPPV symptoms. You may find some drugs that can help you mask your BPPV symptoms by diminishing your sensitivity to your vestibular symptoms, and they work similarly to seasickness medications. Would you please discuss this medicated option with your doctor?

Who Performs BPPV Treatment?

Some vestibular physiotherapists and doctors are trained in assessing and treating BPPV. BPPV-trained physiotherapists undertake specific training to diagnose and successfully treat BPPV. PhysioWorks has several BPPV trained physiotherapists. Would you please call them to book your appointment with a BPPV physiotherapist?

More Info

BPPV - Benign Paroxysmal Positional Vertigo

Vestibular Physiotherapy

Common Causes of Vertigo & Dizziness

Physiotherapy Private Health Insurance Rebates

PhysioWorks Physiotherapy and Remedial Massage are more affordable than you think. Your Private Health Insurance (PHI) usually pays for most of your treatment fees, leaving you with only a small gap payment.

However, Private Health Funds vary their rebates payable depending upon the level of cover you have taken. Some funds have kept up with the costs of modern medicine whereas, sadly, others haven't, with rebates similar to what they were a decade ago.

HICAPS - Instant Health Fund Claims

Most health funds are members of the HICAPS instant claims system. Swipe your health insurance card at our reception counter, and you can instantly claim your physiotherapy treatment via our online Hicaps System. Remedial Massage is claimable via Hicaps for some but not all funds. Please visit Hicaps for the latest funds for more information, which can use their instant claiming system.

Private health insurance rebates are available for all of our physiotherapists. Instant claims are possible via our in-practice Hicaps system.

Third-Party Insurers

PhysioWorks practitioners are registered providers for government, Workcover and insurance companies, including:

  • Workcover
  • InjuryNet
  • Australia Post; Coles Myer; Woolworths
  • Medicare
  • Department of Veterans' Affairs
  • CTP & Sports Insurers

The internet is full of potentially unreliable information. Please source trusted healthcare information from reputable websites such as the following.

British Medical Journal

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