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How is Meniere's disease diagnosed?
The diagnosis of Meniere's disease is primarily made from the history and physical examination. Tinnitus or ear fullness (aural fullness) need to be present to make the diagnosis An audiogram is helpful to show a hearing loss, and to rule-out other abnormalities. It is often helpful, if it can be done safely, to have an audiogram during or immediately following an attack of vertigo. This may show the characteristic low frequency hearing loss. As the disease progresses hearing loss usually worsens.
Other tests such as the auditory brain stem response (ABR), a computerized test of the hearing nerves and brain pathways, computer tomography (CT scan) or, magnetic resonance imaging (MRI) may be needed to rule out a tumor occurring on the hearing or balance nerve. These tumors are rare, but they can cause symptoms similar to Meniere's disease. A full neurological evaluation is performed to exclude other causes of vertigo.
How can Meniere's disease be treated?
- Medications: A diuretic (water pill) such as triamterene (Dyazide, Maxzide) combined with a low salt diet, is the primary treatment of Meniere's disease. Anti-vertigo medications such as meclizine (Antivert, Bonine, Meni-D, Antrizine) mask the symptoms, providing relief, or diazepam (Valium) may provide temporary relief during more severe attacks of vertigo. Anti-nausea medications [for example, promethazine (Phenergan)] sometimes also are prescribed. In some cases, steroids and certain antibiotic medications (gentamicin) injected into the middle ear may provide some relief from vertigo symptoms. Both anti-vertigo and anti-nausea medications may cause drowsiness. Because the nausea can be so severe at times, medications may be prescribed in the form of a suppository
- Air pulse generator: in some patients, periodic delivery of small air pulses transmitted through a tube placed in the ear drum has had some variable success.
- Surgery: If vertigo attacks are not controlled medically and are disabling, for a minority of patients, one of the following surgical procedures may be recommended depending on the individual patient's situation:
Although there is no real cure for Meniere's disease, the attacks of vertigo can be controlled in nearly all cases. If you have vertigo without warning, you should not drive, because failure to control the vehicle may be hazardous to yourself and to others. Safety may require you to forego ladders, scaffolds, and swimming.
Medically reviewed by Peter O'Connor, MD; American Board of Otolaryngology with subspecialty in Sleep Medicine