What are the treatments for the disease?
During an acute attack, individuals are advised to lie flat on a
firm surface and focus on a fixed point. The person should avoid eating or
drinking, which may bring on an episode of vomiting. After the vertigo gets
better, the person will probably need to sleep.
Medicines are tailored for each person, but may include the following:
calcium channel blockers, such as verapamil, flunarizine with cinnarizine,
and nimodipine, that dilate the small blood vessels of the inner ear
diuretics, such as triamterene with hydrochlorothiazide, to help the
kidneys excrete excess fluid from the body
medicines that suppress the activity of the inner ear, such as lorazepam,
meclizine, diazepam, and clonazepam
Steroids, such as prednisone, are used occasionally to
treat Menir's disease. Medicines that suppress the immune system,
such as methotrexate, are used rarely.
People with
infrequent symptoms may not need to be on medicine all the time. It may be best
to treat the attacks as they occur. For those with more frequent attacks,
diuretics can be useful. Otherwise known as "water pills", diuretics work on
the kidneys to excrete excess fluid from the body.
A person with Menir's disease may also be advised to
follow a special diet. A hydrops diet focuses on limiting the intake of
sodium and sugar. This
diet also includes restrictions on excess intake of caffeine, alcohol, and monosodium glutamate, which is also called
MSG. MSG is found in Chinese
foods and some prepackaged foods.
In some cases, a person may have frequent, untreatable
spells of vertigo. The healthcare provider may recommend procedures to destroy
hair cells or nerves in the inner ear. These procedures can take the form of
surgery or medicines, such as certain antibiotics that are toxic to the ear.
Surgery may include removal of the labyrinth or the entire inner ear. This
procedure can be helpful, particularly in individuals who have lost their
hearing. In those who still have reasonable levels of hearing, the balance
nerve can be cut.
What are the side effects of the treatments?
Medicines used to treat Menir's disease commonly cause drowsiness
and dry mouth. Surgery carries a risk of bleeding, infection, hearing impairment, and allergic reaction to anesthesia.
Calcium channel blockers have long been used to treat
Menir's disease as well as high blood pressure. However, the
findings of two recent studies show that people who take a calcium channel
blocker have a much higher incidence of complications than people taking other
medicines for high blood
pressure. The findings of one study, for example, showed that the
risk of heart attack was
27% greater. Also, the risk of
congestive heart failure was 26% higher. The American Heart
Association recommends discussing the risks and benefits of the medicine with a
healthcare provider.
What happens after treatment for the disease?
An appropriate diet combined with medicines can help reduce the frequency and
severity of the attacks. Those whose inner ear structures have been removed
generally become permanently deaf. They may also have chronic problems with
their balance.
How is the disease monitored?
Menir's disease is monitored by evaluating the frequency of the
attacks. The provider will also check for hearing impairment. Any new or worsening symptoms should
be reported to the healthcare provider.
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