Ménière’s disease - Diagnosing Ménière's disease

There's no single test for Ménière's disease, and the condition can be difficult to distinguish from other conditions with similar symptoms.

For example, migraines and ear infections can also affect your balance and hearing. A viral infection of the balance nerve (vestibular neuronitis) or the inner ear (labyrinthitis) can also produce similar vertigo attacks.

Seeing your GP

See your GP if you experience any of the symptoms of Ménière's disease.

They'll ask you to describe your symptoms to find out if a pattern is emerging that could indicate Ménière's disease.

For Ménière's disease to be diagnosed, you'll need to have the following characteristic symptoms:

• vertigo (a feeling that the environment around you is spinning) – at least two episodes of vertigo lasting 20 minutes or more within a single Ménière's disease attack
• hearing loss – tests must confirm that hearing loss is caused by damage to the sensitive hair cells inside the cochlea (the coiled tube in the inner ear)
• tinnitus (hearing noises from within your body) or a feeling of pressure in your ear

Your GP may also carry out a general physical examination to rule out other possible causes of your symptoms. This may involve listening to your heartbeat, checking your blood pressure and examining the inside of your ears.

Seeing a specialist

If necessary, your GP can refer you to a specialist for further tests.

In most cases, you'll probably be referred to an ear nose and throat (ENT) specialist at the ENT department of your local hospital.

You can also be referred to a specialist in audiovestibular medicine for hearing and balance assessment, although this service may not be available in every hospital.

Hearing tests

The specialist will be able to assess the extent of your hearing loss by using hearing tests, such as an audiometry test.

During an audiometry test, you listen to sounds of different volume and pitch produced by a machine and signal when you hear a sound, either by raising your hand or pressing a button.

Read more about how hearing tests are carried out.

Videonystagmography

Videonystagmography (VNG) may be used to check for signs of uncontrollable eye movements (nystagmus) because this can indicate a problem with balance.

During this test, special goggles are placed over your eyes and you'll be asked to look at various still and moving targets. The goggles are fitted with a video camera to record your eye movements.

Caloric testing

A caloric test involves putting warm and cool water or air in your ear for about 30 seconds. The change in temperature stimulates the balance organ in the ear, allowing the specialist to check how well it's working.

This test isn't painful, although it's normal to feel dizzy for a few minutes afterwards.

Electrocochleography

Electrocochleography is a test used to measure how your hearing nerves respond to sound.

During this test, a series of electrodes are attached to your head and a thin probe or needle is passed into your ear so it touches or passes through your eardrum. Local anaesthetic will be used to numb your eardrum before the procedure if a needle is going to be passed through it.

You will then listen to a series of loud clicks, while the activity of your nerves is picked up by the electrodes and probe or needle.

Scans

In some cases, a magnetic resonance imaging (MRI) scan of your head may be carried out to look for any abnormalities in your brain – such as an acoustic neuroma (a non-cancerous tumour) – that could be causing your symptoms.

Vertigo
Vertigo is the sensation that you or the environment around you is moving or spinning.

Tinnitus
Tinnitus is the medical name for the perception of noise in one ear, both ears or in the head. The noise comes from inside the body rather than an outside source.