The disease tends to occur more often in adults than children and affects women more often than men. The condition affects only one ear in most patients. Both ears may be affected in 20-25% of the patients with Meniere's disease.

CAUSE AND TREATMENT The underlying abnormality is an increase in the amount of fluid in the inner ear. The increased amount of fluid increases pressure in the inner ear. This pressure affects balance and hearing. The exact cause for the increased fluid remains unknown.

An attack usually begins with incapacitating episodes of vertigo associated with nausea and vomiting. Often the vertigo is so severe that a person cannot stand. For many people, a sensation of fullness in the affected ear and worsening tinnitus associated with hearing loss precedes the vertigo.

Acute attacks last a few hours, but it may take several days before a person feels normal again. As attacks subside, hearing and tinnitus improve. Initially, hearing loss predominantly affects low pitched sounds, but later all sound frequencies may be affected. For most people, hearing diminishes with each successive attack, and the loss may become permanent.

A person may experience a number of attacks over a period of days to weeks followed by symptom-free periods. This leads to the erroneous assumption that the problem has gone away. Unfortunately, the attacks recur, and there is no way to predict when one will occur or how long the periods between attacks will last.

A thorough evaluation is necessary to exclude other problems. Physical examination reveals a normal appearance of the ear and no other neurological signs or symptoms. hearing tests define the degree of hearing loss, and balance testing may reveal a diminished response of the inner ear on the affect side. Imaging studies are sometimes done to rule out other causes of vertigo, such as an acoustic neuroma, a type of non-malignant tumor that sometimes produces similar symptoms.

The treatment of Meniere's disease is both medical and surgical. Drugs enable most patients to obtain some relief of symptoms during an acute attack. Dramamine or Antivert help some people's vertigo. Recently, medication applied to the skin behind the ear has been used to improve vertigo. It is difficult to assess the response to these drugs in a condition that comes and goes as unpredictably as Meniere's disease. Usually a diuretic, or water pill, is prescribed to decrease inner ear fluid pressure. Nicotine and caffeine reduce blood flow to the inner ear and therefore should be avoided. Based on this, we recommend you stop smoking and limit intake of coffee, tea and soft drinks.

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