Meniere’s disease is a chronic inner ear disorder that impacts both balance and hearing. It stems from an abnormal buildup of fluid, known as endolymph, within the inner ear’s labyrinth, which houses structures vital for hearing and balance. It typically causes recurring symptoms, including episodes of vertigo, a sensation of spinning, along with fluctuating hearing loss, tinnitus (ringing or other sounds in the ear), and a feeling of fullness or pressure in the affected ear. While the exact cause of this fluid buildup remains unclear, Meniere’s disease is considered a progressive condition, meaning its symptoms tend to worsen over time.
Early Stage
The early stage of Meniere’s disease is characterized by intermittent and unpredictable symptoms. Individuals typically experience sudden, intense episodes of vertigo, where they feel as though they or their surroundings are spinning. These vertigo attacks can last from 20 minutes to several hours, but usually not more than 24 hours, and are frequently accompanied by nausea and vomiting. These episodes can be severe, potentially making everyday activities challenging.
During this early stage, hearing loss is common, primarily affecting low frequencies, and tends to fluctuate; hearing may return to normal or near-normal levels between attacks. Tinnitus also occurs intermittently, often appearing before or during a vertigo episode. A sense of pressure or fullness in the affected ear also comes and goes. Between these acute episodes, individuals often experience periods that are largely symptom-free, offering temporary relief from the disruptive effects of the disease.
Middle Stage
In the middle stage, the pattern of symptoms typically shifts. Vertigo attacks may continue, though their intensity and frequency can vary, sometimes becoming less severe than in the early stage. Hearing loss generally becomes more persistent and begins to affect a broader range of frequencies, rather than being limited to just low tones. While hearing may still fluctuate, periods of normal hearing become less common.
Tinnitus and the sensation of ear fullness often transition from intermittent occurrences to more constant companions. Their continuous presence can become a more persistent source of discomfort and disruption. Additionally, individuals may start to experience a mild sense of imbalance or unsteadiness even during the periods between vertigo attacks. These persistent balance issues signify a more entrenched impact of the disease on the inner ear’s function, moving beyond the acute episodes of spinning.
Late Stage
In the late stage, the long-term effects become more pronounced and enduring. Severe vertigo attacks that characterized earlier stages may diminish in frequency or even cease entirely. However, this reduction in vertigo often coincides with the development of chronic balance problems and pervasive unsteadiness, which can affect daily life even when not experiencing an acute attack. These balance difficulties can be particularly noticeable in low-light conditions or when walking on uneven surfaces.
Hearing loss in the late stage is typically severe and permanent, affecting all frequencies and often progressing over time. This permanent impairment significantly impacts communication and overall quality of life. Tinnitus and the feeling of ear fullness are usually constant. A small percentage of individuals may also experience sudden “drop attacks,” where they lose balance and fall without losing consciousness. This phenomenon highlights the severe disruption to the balance system that can occur in the late stages.