A 42-year-old woman has experienced episodes of dizziness, ringing in the ears (tinnitus), and a sense of fullness in her ears. She says she has had these episodes over the past year. She is worried that she might have Meniere's disease.
Meniere's disease happens when too much fluid builds up in the compartments of the inner ear that contain structures that control balance and hearing. These compartments, called the labyrinth, are filled with fluid called endolymph. In the balance organs, this fluid stimulates receptors that send signals to the brain about body movement. In the cochlea, this fluid is compressed in response to sound vibrations, and this stimulates sensory cells that send signals to the brain about sounds.
During an attack of Meniere's, the fluid causes symptoms that vary in duration and intensity. They often occur in one ear, and can last for up to four hours. Most people experience severe vertigo, a spinning sensation, which is usually described as a horizontal merri-go-round type of feeling. This is often accompanied by a sense of imbalance and nausea or vomiting. In between attacks, hearing and the sensation in the ear return to normal.
Some medications can ease the symptoms of Meniere's disease. Medicines that treat motion sickness, such as meclizine and diazepam, might help with the spinning sensation, while antiemetics might control nausea or vomiting. Medications that reduce the buildup of fluid, such as diuretics and betahistine, may also improve vertigo.