Progression

What is the typical course of Meniere's Disease? This question is difficult to answer satisfactorily because individual cases are extremely variable. Some patients will have only one attack, never to be bothered again. Another group of patients will have their initial episode which is followed by a symptom-free period which may last many years. Symptoms then return and can be quite sporadic.

The more typical history of Meniere's Disease is one of repeated bouts of vertigo, tinnitus, and hearing loss. These attacks can vary in frequency from once to several times per year. There can be considerable variation in the symptom-free intervals. In addition, the symptoms can vary in their intensity and duration from one attack to another. The disease can continue in this unpredictable fashion for several years and will often "burn out" after a period of 8-10 years. In the process of "burning out", vertigo will tend to become less severe and less frequent. At the same time, hearing will have a tendency to recover less and less after each attack until, unfortunately, many patients become deaf in the affected ear. In 70% of Meniere's patients, vertigo will resolve under medical treatment alone in 8-10 years.

Some doctors say that Meniere's "burns itself out," leading patients to falsely believe that Meniere's will simply fade away and they will be "cured."  However, "burnout" refers to a condition where Meniere's has progressed to the point where it has finally destroyed the vestibular function the affected ear in its entirety.  At the point of burnout, the patient has no vestibular function left and the body may or may not compensate in other ways.  The vestibular function in the other ear may take over and/or the patient may learn to balance through visual cues (with some degree of difficulty occurring during darkness).  However, nothing stops the relentless destruction of Meniere's, and it will continue to destroy hearing, produce the sense of fullness, and produce tinnitus -- even in patients who are deaf because of Meniere's or otherwise.  Some patients are said to reach burnout after roughly eight years; some take more time, some take less time, and some patients never reach burnout.  It is not possible to predict how whether burnout will happen at all or, if it does, how long that might take, for any one given individual patient.  For those who do progress to burnout, the body may or may not compensate well and, unfortunately, there is always the possibility of developing bilateral Meniere's.  While some patients reach a nearly vertigo-free state of burnout, burnout is not a cure and there is no certainty any one patient reaching burnout.

In some patients, Meniere's Disease takes a more debilitating course. This group of patients will suffer frequent, severe bouts of vertigo, tinnitus and hearing loss. So much so that they cannot work, drive an automobile, or even walk about without fear of falling. These severe symptoms can persist in spite of aggressive medical therapy, including diet modification. It is these patients that most often undergo surgery to control their vertigo symptoms.