Chapter 7
Ménière’s Disease: A Patient’s Odyssey
John L. Dornhoffer, MD

Department of Otolaryngology
University of Arkansas Medical School
Little Rock, AR

. . .Susan, a wife and mother of two, was 31 years of age when her symptoms first appeared. She woke up from a nap and everything was spinning. This episode of vertigo lasted for over an hour, making her feel weak and sick with nausea. A few days later, the dizziness attacked again although it subsided more quickly and didn’t seem as severe. Susan then started to notice a roaring sound in her right ear, as if a waterfall was cascading through her head. She also had a feeling of pressure in the same ear, the same feeling she had when she was flying and the airplane started to descend. Not linking these symptoms with her dizzy attacks, Susan thought she had an ear infection since she had been plagued by these as a young child. However, she had no feelings of pain in her ear and a short round of antibiotics seemed to make no difference.

Ménière’s Symptoms

The symptoms of Ménière’s disease typically appear in individuals between the ages of 30 and 50 years, but there are many exceptions to this. Ménière’s disease is actually a rare condition. According to the National Institutes of Health List of Rare Diseases, there are less than 200,000 cases in the U.S. Some researchers have described Ménière’s disease as being familial, meaning it can run in families, particularly when the symptoms are associated with migraine headaches. It is estimated that 10-15 percent of patients experience bilateral Ménière’s disease, with symptoms occurring in both ears.

Susan made an appointment with her family physician. Although her attacks of vertigo were never quite as severe as the first one she had experienced, they were still occurring on a fairly frequent basis. She was becoming afraid to drive, especially when her children were in the car, because she might experience a dizzy attack. In addition, the feeling of pressure (or aural fullness) was now occurring more frequently. She had nearly convinced herself of the worst-case scenario—a brain tumor. Fortunately, her family physician was able to calm her fears. He thought she was still experiencing an ear infection and explained that an ear infection could also cause disequilibrium (dizziness). He prescribed cortisone to reduce any swelling in the inner ear and relieve the pressure, as well as a different round of antibiotics to clear up the infection. Susan left the doctor’s office confident that all her symptoms would soon be going away.

The symptoms of Ménière’s disease can pose as many other illnesses, causing frustration, anxiety and depression in the patient suffering from this disease as he or she tries to cope with the attacks of vertigo while attempting to determine the cause. Until a diagnosis is confirmed, many patients start to feel as if they’re going crazy and their colleagues may even accuse them of shirking work duties and faking symptoms. . .