A diagnosis of Meniere's disease requires:
- Two spontaneous episodes of vertigo, each lasting 20 minutes or longer
- Hearing loss verified by a hearing test on at least one occasion
- Tinnitus or aural fullness
- Exclusion of other known causes of these sensory problems
If you have signs or symptoms associated with Meniere's disease, your doctor will ask you questions about your sensory problems, order tests that evaluate the quality of inner ear function and order other tests to screen for possible causes of the problems.
Physical examination and medical history
Your doctor will conduct a physical examination and ask questions about:
- The severity, duration and frequency of the sensory problems
- Your history of infectious diseases or allergies
- Medication use
- Past ear problems
- Your general health
- History of inner ear problems in your family
A hearing test (audiometry) assesses how well you detect sounds at different pitches and volumes and how well you distinguish between similar-sounding words. The test not only reveals the quality of your hearing but also may help determine if the source of hearing problems is in the inner ear or the nerve that connects the inner ear to the brain.
Between episodes of vertigo, the sense of balance returns to normal for most people with Meniere's disease. But there may be some degree of ongoing balance problems.
There are several tests that assess function of the inner ear. Some or all of these tests can yield abnormal results in a person with Meniere's disease.
Videonystagmography (VNG). This test evaluates balance function by assessing eye movement. Balance-related sensors in the inner ear are linked to muscles that control movement of the eye in all directions. This connection is what enables you to move your head around while keeping your eyes focused on a single point.
In a VNG evaluation, warm and cool water or warm and cool air are introduced into the ear canal. Measurements of involuntary eye movements in response to this stimulation are performed using a special pair of video goggles. Abnormalities of this test may indicate an inner ear problem.
- Rotary-chair testing. Like a VNG, this measures inner ear function based on eye movement. In this case, stimulus to your inner ear is provided by movement of a special rotating chair precisely controlled by a computer.
- Vestibular evoked myogenic potentials (VEMP) testing. VEMP testing measures the function of sensors in the vestibule of the inner ear that help you detect acceleration movement. These sensors also have a slight sensitivity to sound. When these sensors react to sound, tiny measurable variations in neck or eye muscle contractions occur. These contractions serve as an indirect measure of inner ear function.
- Posturography. This computerized test reveals which part of the balance system — vision; inner ear function; or sensations from the skin, muscles, tendons and joints — you rely on the most and which parts may cause problems. While wearing a safety harness, you stand in bare feet on a platform and keep your balance under various conditions.
Tests to rule out other conditions
Other tests may be used to rule out disorders that can cause problems similar to those of Meniere's disease, such as a tumor in the brain or multiple sclerosis. These tests include:
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- Magnetic resonance imaging (MRI). This technique uses a magnetic field and radio waves to create images of soft tissues in the body. It can be used to produce either a thin cross-sectional "slice" or a 3-D image of your brain.
- Computerized tomography (CT). This X-ray technique produces cross-sectional images of internal structures in your body.
- Auditory brainstem response audiometry. This is a computerized test of the hearing nerves and hearing centers of the brain. It can help detect the presence of a tumor disrupting the function of auditory nerves.
- Flint PW, et al. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05283-2..X0001-8--TOP&isbn=978-0-323-05283-2&uniqId=230100505-57. Accessed Aug. 31, 2012.
- Meniere's disease. Vestibular DisordersAssociation. http://vestibular.org/menieres-disease. Accessed Aug. 31, 2012.
- Dinces EA, et al. Meniere disease. http://www.uptodate.com/index. Accessed Aug. 30, 2012.
- Lalwani AK. Current Diagnosis & Treatment in Otolaryngology — Head & Neck Surgery. 3rd ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=39. Accessed Aug. 29, 2012.
- Rauch SD. Clinical hints and precipitating factors in patients suffering from Meniere's disease. Otolaryngologic Clinics of North America. 2010;43:1011.
- Heart attack, stroke and cardiac arrest warning signs. American Heart Association. http://www.heart.org/HEARTORG/General/Heart-Attack-Stroke-and-Cardiac-Arrest-Signs_UCM_303977_SubHomePage.jsp. Accessed Aug. 31, 2012.
- Meniere's disease. American Academy of Otolaryngology — Head and Neck Surgery. http://www.entnet.org/HealthInformation/menieresDisease.cfm. Accessed Aug. 31, 2012.
- Meniere's disease. National Institute on Deafness and Other Communication Disorders. http://www.nidcd.nih.gov/health/balance/pages/meniere.aspx. Accessed Aug. 31, 2012.
- Potassium. American Cancer Society. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/potassium. Accessed Aug. 31, 2012.
- Sodium (salt or sodium chloride). American Heart Association. http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyDietGoals/Sodium-Salt-or-Sodium-Chloride_UCM_303290_Article.jsp. Accessed Aug. 31, 2012.
- Neff BA (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 18, 2012.
- Neff BA, et al. Auditory and vestibular symptoms and chronic subjective dizziness in patients with Meniere's disease, vestibular migraine, and Meniere's disease with concomitant vestibular migraine. Otology & Neurotology. 2012;33:1235.