All about Meniere's disease, labyrinthitis, vertigo and dizziness

One of the most common reasons for patients coming to see me is dizziness. These have a dizzying array of causes, and your doctor will need to ask lots of questions to tease out the culprit.

Dizziness accompanied by a spinning sensation is called vertigo. Often brought on by movement, it tends to be worse when you sit or stand up. You'll often feel or be sick, and may not have any choice but to take to your bed. It's usually down to a problem in your inner ear.

Inside your inner ear is a labyrinth of tiny channels filled with fluid, which detect movement and send messages to your brain about your head position, helping you keep your balance.

This is closely linked to another structure in your inner ear called the cochlea - this helps with hearing. Inflammation or damage to your labyrinth - known as labyrinthitis - causes vertigo. It can be caused by a viral infection, inner ear injury, blocked blood supply to part of your brain or occasionally a medication side effect.

Many people get just a single episode, lasting a few days or weeks. This is often caused by a viral infection, and while you may feel very unwell at the time, you'll usually recover with no ill effects.

Others get intermittent bouts of vertigo, usually triggered by moving your head. This 'BPPV' is due to a tiny solid piece of debris in the labyrinth which moves around, triggering the wrong messages to your brain about your position. A series of movements called the Epley manoeuvre, carried out by a doctor, may dislodge this debris and solve the problem.A condition called Meniere's disease can also lead to bouts of vertigo, usually lasting two to four hours. However, in Meniere's disease these episodes will be accompanied by:

  • Partial loss of hearing, often only in one ear to begin with
  • Tinnitus (a ringing, buzzing or roaring in the ears)
  • Sometimes a feeling of pressure inside the ears.

Meniere's disease is thought to be due to temporary build-up of fluid in the labyrinth. It's not common - it affects about one in 1000 people and mostly starts when a person reaches their 50s or 60s. Even if hearing is affected permanently by Meniere's, such patients should be able to benefit from a hearing aid

Safety measures, like avoiding ladders and not swimming alone, can prevent accidents if you do get a sudden attack of vertigo. After experiencing vertigo, you may feel sleepy and slightly unsteady on your feet for a day or so. Some people go for months between these episodes, although they can come in clusters with a few attacks occurring over a week or so, followed by a gap. Over time, the accompanying tinnitus may become permanent and your hearing may not return to normal between attacks.

If you drive, you have a legal duty to let the DVLA (which governs driving in the UK) know if you develop sudden attacks of disabling giddiness, including those caused by Meniere's disease. You also need to inform your car insurance company. Once the DVLA gets your notification form (apply to DVLA directly or your GP can help) they'll look at your individual case. You may be able to keep your existing license or get a new time-limited one. You do need to stop driving until you've had your case assessed by the DVLA.

Most people with Meniere's find that they stop getting acute bouts of vertigo eventually, although this may take five to 10 years. In the meantime, medicine can help. Some people just take tablets when they get an attack. These are designed to dampen down the abnormal signals that get sent from the inner ear to the brain, and can help with dizziness and particularly sickness. If you get more frequent attacks, you may be offered regular treatment with a tablet called betahistine.

Although there's not much evidence that lifestyle measures relieve the symptoms of Meniere's, some sufferers say they get benefit from a low-salt diet (which may reduce the inner ear fluid build up) or from regular exercise and relaxation techniques.

With thanks to 'My Weekly' magazine where this article was originally published.

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.