Ménière's disease

Graphic courtesy drmkotb.com

Ménière's disease usually affects only one ear. Involvement of the other ear is approximately 25 - 30 per cent.

The precise causes of the Ménière's disease are not fully understood.

Symptoms of Ménière's disease include:

• Nerve hearing loss (sensorineural): usually one-sided and fluctuating in nature
• Tinnitus: subjective noise a patient can hear in the ear — a high pitched continuous tone that can fluctuate with hearing loss
• Vertigo attacks: usually the most dramatic and disabling part of the disease, often accompanied by nausea and vomiting — this can vary in frequency and duration (may last many hours)
• Other: fullness in the ear, discomfort with loud noise, drop attacks, constant sense of imbalance

Dizziness or hearing loss can predominate in Ménière's disease.

Diagnosis

Diagnosis of Ménière's disease is primarily based on clinical features. It may be supported by hearing tests (audiograms) and balance tests (ENG).

A wide spectrum of presentation and disease progression is seen for Ménière's. A large number of patients will have mild balance symptoms, and slowly deteriorating hearing with little functional impact. Others will experience severe hearing fluctuation and incapacitating vertigo attacks. The pattern is usually established in the first few years of the disease.