Your doctor will conduct an exam and take a medical history. A diagnosis of Meniere's disease requires:
- Two episodes of vertigo, each lasting 20 minutes or longer but not longer than 24 hours
- Hearing loss verified by a hearing test
- Tinnitus or a feeling of fullness in your ear
- Exclusion of other known causes of these problems
A hearing test (audiometry) assesses how well you detect sounds at different pitches and volumes and how well you distinguish between similar-sounding words. People with Meniere's disease typically have problems hearing low frequencies or combined high and low frequencies with normal hearing in the mid frequencies.
Between episodes of vertigo, the sense of balance returns to normal for most people with Meniere's disease. But you might have some ongoing balance problems.
Tests that assess function of the inner ear include:
Videonystagmography (VNG). This test evaluates balance function by assessing eye movement. Balance-related sensors in the inner ear are linked to muscles that control eye movement. This connection enables you to move your head while keeping your eyes focused on a 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.
- Rotary-chair testing. Like a VNG, this measures inner ear function based on eye movement. You sit in a computer-controlled rotating chair, which stimulates your inner ear.
- Vestibular evoked myogenic potentials (VEMP) testing. This newer test shows promise for not only diagnosing, but also monitoring Meniere's disease. It shows characteristic changes in the affected ears of people with Meniere's disease.
- 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.
- Video head impulse test (vHIT). This newer test uses video to measure eye reactions to abrupt movement. While you focus on a point, your head is turned quickly and unpredictably. If your eyes move off the target when your head is turned, you have an abnormal reflex.
- Electrocochleography (ECoG). This test looks at the inner ear in response to sounds. It might help to determine if there is an abnormal buildup of fluid in the inner ear, but isn't specific for Meniere's disease.
Tests to rule out other conditions
Blood tests and others 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. An imaging test, such as an MRI, also might be used.
Nov. 26, 2015
- Dinces EA, et al. Meniere disease. http://www.uptodate.com/home. Accessed Oct. 3, 2015.
- Meniere's disease. American Academy of Otolaryngology — Head and Neck Surgery. http://www.entnet.org/content/menieres-disease. Accessed Oct. 3, 2015.
- AskMayoExpert. Recurrent vertigo. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015.
- Foster CA. Optimal management of Meniere's disease. Therapeutics and Clinical Risk Management. 2015;11:301.
- Meniere's disease. Vestibular Disorders Association. http://vestibular.org/menieres-disease. Accessed Oct. 3, 2015.
- 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.
- Bisdorff AR, et al. Overview of the international classification of vestibular disorders. Neurological Clinics. 2015;33:514.
- Furman JM, et al. Evaluation of the patient with vertigo. http://www.uptodate.com/home. Accessed Oct. 5, 2015.
- Ferrarro JA, et al. Electrocochleography in the evaluation of patients with Maniere's disease/endolymphatic hydrops. Journal of the American Academy of Audiology. 2006;17:45.