Diagnosis of Ménière’s disease

Self-diagnosis checklist

Early diagnosis of Ménière’s is important so that you can begin treatments that may help reduce the long-term effects of the disease. If you suspect you have symptoms of Ménière’s disease complete the checklist below.

Instructions

If you have a symptom check the box beside it. See the Symptoms page if you need more information about the various symptoms.

	Important If you check more than six boxes we strongly recommend that you have your condition evaluated by an ENT (Ear, Nose and Throat) specialist (see below).
		Vertigo (dizziness)
		Rotational vertigo (room appears to spin)
		Lasts longer than 10 minutes
		Associated with hearing loss
		Associated with tinnitus (ringing noise in ears or head)
		Hearing loss
		Hearing loss
		Low frequency loss (can't hear low sounds)
		Fluctuates
		Tinnitus (ringing noise in ears or head)
		Lasts more than 10 minutes
		Associated with dizziness
		Feeling of fullness or pressure in the ear
		Associated with vertigo
	Checklist devised by Professor William P R Gibson AM, MD FRACS - Professor of Otolaryngology, Royal Prince Hospital, Sydney

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Professional medical diagnosis

If you have a typical history of 'classic' Ménière’s symptoms most doctors can diagnose Ménière’s without any special tests. However tests are recommended to confirm the diagnosis and assess the severity of your condition. Typical tests include:

• blood tests, a CT scan (CAT scan) or an MRI scan to exclude other conditions that have similar symptoms to Ménière’s e.g. acoustic neuroma (tumour)
• a physical examination of the ears, head and neck, and the part of the nervous system related to balance
• a full investigation of hearing and balance function to confirm the diagnosis of Ménière’s and to assess its severity.

Hearing tests

Hearing tests may include:

• assessment of hearing in both ears using pure tone and speech discrimination tests
• electrophysiological tests to examine the function of the inner ear and the hearing nerves
• electrocochleography – an ‘evoked response’ audiometry test that measures the response of the inner ear to sound stimuli introduced to the external auditory canal or middle ear
• dehydration tests - drugs are used to reduce fluid in the ear and any resultant changes in hearing are measured

Balance tests

Balance tests are used to:

• determine which ear is affected
• assess the level of balance lost
• to assess the brain’s compensation for the damage in the ear

These tests make use of the connection between your inner ear and eyes in order to assess how well your balance mechanisms are working. They record and assess eye movement in response to head movement, body movement, rotation or temperature stimulation of the ears. For example:

• harmonic acceleration tests involve sitting in a rotating chair with the lights turned off and checking to see if your inner ear is detecting the rotation.
• caloric testing involves stimulating the horizontal semicircular canal in the inner ear by introducing warm or cold water (or air) into the outer ear canal and recording the resulting eye movements.

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Last reviewed March 2008