Meniere Disease

Triad of vertigo attacks, fluctuating hearing loss, and tinnitus

Overview

Meniere disease is an inner ear disorder associated with endolymphatic hydrops, an excess of fluid in the endolymphatic spaces of the inner ear. Classic attacks combine episodes of spinning vertigo lasting from about 20 minutes to several hours, fluctuating low frequency sensorineural hearing loss, roaring tinnitus, and a sense of fullness in the affected ear. Attacks cluster unpredictably and then remit, and diagnosis relies on the pattern of symptoms over time together with audiometry. It is named after the French physician Prosper Meniere, who in 1861 proposed that vertigo could arise from the inner ear rather than the brain. Management approaches include dietary salt reduction, diuretics, betahistine in some countries, and vestibular rehabilitation, while persistent cases may be treated with intratympanic steroids or gentamicin, and rarely surgery. Over years the attacks often become less frequent, but some permanent hearing loss commonly remains. It usually begins in middle age and a minority of cases run in families.