How is Meniere Syndrome diagnosed?

Diagnosing Meniere Syndrome

Meniere Syndrome is a disorder of the inner ear that affects balance and hearing. It is characterized by recurring episodes of vertigo, hearing loss, tinnitus (ringing in the ears), and a feeling of fullness or pressure in the affected ear. Diagnosing Meniere Syndrome can be challenging as its symptoms can mimic other conditions. However, there are several key diagnostic methods that healthcare professionals use to identify this condition.

Medical History and Physical Examination

The first step in diagnosing Meniere Syndrome is a thorough medical history and physical examination. The healthcare provider will ask about the patient's symptoms, their frequency and duration, and any triggers that may be associated with the episodes. They will also inquire about the patient's medical history, including any previous ear infections or head injuries.

During the physical examination, the healthcare provider will assess the patient's balance, coordination, and eye movements. They will also examine the ears using an otoscope to check for any abnormalities or signs of infection.

Hearing Tests

Hearing tests, also known as audiometric tests, are crucial in diagnosing Meniere Syndrome. These tests evaluate the patient's hearing ability and can help determine the extent of hearing loss. The two most common hearing tests used are:

• Pure-tone audiometry: This test involves wearing headphones and listening to tones at different frequencies and volumes. The patient indicates when they can hear the tones, allowing the healthcare provider to create an audiogram that shows the patient's hearing thresholds.


• Speech audiometry: This test assesses the patient's ability to hear and understand speech. The patient listens to words or sentences at different volumes and repeats them back. This helps determine the patient's speech reception threshold and word recognition score.

Vestibular Tests

Vestibular tests are designed to evaluate the patient's balance and the function of the inner ear. These tests can help differentiate Meniere Syndrome from other balance disorders. Some common vestibular tests include:

• Videonystagmography (VNG): This test measures eye movements using infrared cameras to assess the function of the vestibular system. The patient may be asked to track moving objects with their eyes or perform specific head movements while wearing goggles.


• Caloric testing: This test involves irrigating the ear canal with warm or cool water to stimulate the inner ear. The resulting eye movements are recorded and analyzed to evaluate the function of the vestibular system.


• Vestibular evoked myogenic potentials (VEMP): This test measures the response of certain muscles in the neck or eyes to sound or vibration stimuli. It helps assess the integrity of the vestibular system.

Imaging Tests

In some cases, imaging tests may be necessary to rule out other possible causes of the symptoms. Magnetic resonance imaging (MRI) or computed tomography (CT) scans can help visualize the structures of the inner ear and rule out tumors or other abnormalities.

Diagnostic Criteria

There are specific diagnostic criteria established by the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) to aid in the diagnosis of Meniere Syndrome. These criteria include:

• Two or more spontaneous episodes of vertigo lasting at least 20 minutes each


• Hearing loss confirmed by audiometry in the affected ear


• Tinnitus or aural fullness in the affected ear


• Exclusion of other known causes of these symptoms

Consultation with Specialists

In complex cases or when the diagnosis is uncertain, healthcare providers may refer patients to specialists such as otolaryngologists (ear, nose, and throat specialists) or neurologists. These specialists have expertise in diagnosing and managing inner ear disorders, including Meniere Syndrome.

It is important to note that diagnosing Meniere Syndrome can be challenging due to the variability of symptoms and the need to rule out other conditions. Therefore, it is crucial to consult with a healthcare professional for an accurate diagnosis and appropriate management.