From the Guidelines
Meniere's disease is diagnosed in patients presenting with 2 or more episodes of vertigo lasting 20 minutes to 12 hours (definite) or up to 24 hours (probable) and fluctuating or nonfluctuating sensorineural hearing loss, tinnitus, or pressure in the affected ear 1.
Diagnostic Criteria
The diagnostic criteria for Meniere's disease include:
- 2 or more episodes of vertigo lasting 20 minutes to 12 hours (definite) or up to 24 hours (probable)
- Fluctuating or nonfluctuating sensorineural hearing loss
- Tinnitus
- Pressure in the affected ear These symptoms should not be better accounted for by another disorder.
Evaluation
When assessing a patient for Meniere's disease, clinicians should:
- Obtain an audiogram to evaluate hearing loss 1
- Ask questions to get a history of symptoms, including frequency, duration, and severity of vertigo, hearing loss, tinnitus, and ear fullness
- Consider additional testing, such as magnetic resonance imaging (MRI) of the internal auditory canal (IAC) and posterior fossa, if symptoms are not better accounted for by another disorder 1 Note that clinicians should not routinely order vestibular function testing or electrocochleography to establish the diagnosis of Meniere's disease 1.
From the Research
Diagnostic Criteria for Meniere's Disease
The diagnostic criteria for Meniere's disease are based on clinical criteria and can be categorized into two main types: definite Meniere's disease and probable Meniere's disease 2, 3, 4.
- Definite Meniere's disease is diagnosed when there is an episodic vertigo syndrome associated with low- to medium-frequency sensorineural hearing loss and fluctuating aural symptoms (hearing, tinnitus, and/or fullness) in the affected ear 2, 3, 4.
- Probable Meniere's disease is a broader concept defined by episodic vestibular symptoms (vertigo or dizziness) associated with fluctuating aural symptoms occurring in a period from 20 minutes to 24 hours 2, 3, 4.
Duration of Vertigo Episodes
The duration of vertigo episodes is limited to a period between 20 minutes and 12 hours for definite Meniere's disease 2, 3, 4.
Challenges in Diagnosis
The diagnosis of Meniere's disease can be challenging in individual patients, particularly in those with monosymptomatic presentation or an early stage of the disease 5. Long-term follow-up with repeated audiometry is advisable to confirm the diagnosis 5.
Audiometric and Electrocochleographic Data
Audiometric and electrocochleographic data can be used to support the diagnosis of Meniere's disease 6. The Meniere's Disease Index, which is based on a combination of audiometric and electrocochleographic measures, can be used as an objective correlate of Meniere's disease 6.