Conditions: Meniere’s Disease

Meniere’s disease

Ménière's disease is a chronic disorder of the inner ear that is characterized by recurrent episodes of feeling like the world is spinning (vertigo), ringing or roaring in the ears (tinnitus), hearing loss (usually in the low to middle frequencies), and a feeling of fullness or pressure in the ear on the affected side. These four symptoms may not all appear at once—many people first notice only fluctuating hearing changes or spinning spells, and the full picture can take months or even years to emerge. Typically, only one ear is affected initially; however, over time both ears may become involved. Progression to both ears (bilateral disease) happens in roughly 10% to 50% of people over the course of the illness, on average about 8 years after symptoms begin, though it can occur decades later.

The disease affects an estimated 50 to 200 of every 100,000 adults and most often begins between the ages of 40 and 60, with a slight predominance in women.

Episodes generally last from 20 minutes to a few hours—usually less than 12 hours—and a variable length of time may pass between episodes. Some people have several attacks in a single week, while others go months or years symptom-free, and attacks often cluster together followed by long periods of remission. Hearing loss and ringing may at first be present only during attacks, but over time the hearing loss tends to become permanent and can slowly worsen, sometimes progressing to severe or profound loss in the affected ear.

What causes Ménière's disease?

The exact cause is not fully understood. The symptoms are thought to come from a buildup of fluid (called endolymph) inside the inner ear, a condition known as endolymphatic hydrops. This excess fluid is believed to disrupt the delicate structures responsible for hearing and balance. Some cases run in families, and there is a well-recognized overlap with migraine—more than half of people with Ménière's disease also have a history of migraine, which can make the two conditions hard to tell apart.

How is Ménière's disease diagnosed?

Meniere’s disease is diagnosed by the presence of episodes of

There is no single test that confirms Ménière's disease. The diagnosis is made by a clinician based on your pattern of symptoms over time, along with a hearing test (audiogram) that can document the characteristic low-frequency hearing loss. Additional tests, such as balance testing or an MRI, are sometimes done mainly to rule out other conditions that can mimic Ménière's disease, such as vestibular migraine, inner-ear inflammation, or, rarely, a tumor on the hearing nerve.

Additional resources I recommend:

• Frequently asked questions about Meniere’s disease, from ENTHealth.org.

• Plain language summary of Meniere’s disease from The Academy of Otolaryngology—Head and Neck Surgery. This is excellent.

• A more detailed description of Meniere’s disease by Vestibular Disorders Association.

• Animated video describing Meniere’s disease

• Ménière’s Resources Inc.: http://menieresresources.org

• Ménière’s Society: http://www.menieres.org.uk

• Ménière’s Research Fund, Inc.: https://menieresresearchaustralia.org

• Hearing Health Foundation: https://hearinghealthfoundation.org