Because the exact cause of Meniere's Disease is still unknown, it
is really important to get a correct diagnosis. To arrive at a firm and supportive
diagnosis and in order to rule out other problems, a very detailed history and
physical examination will be required. Several tests using technology will also
be ordered. Most than likely you will be sent to one or more specialists: an
otolaryngologist (ear nose and throat) or a neurologist (brain). The eyes, ears,
and brain are in close proximity.
The fluid-filled semicircular canals of the inner ear, plus the 8th cranial
nerve, control balance and our sense of position. Meniere's Disease involves
a swelling of the part of that canal that controls the filtration and excretion
of the fluid in the inner ear.
Each individual's case must be checked against the possible cause of middle
ear infections, otitis media, syphilis, or head injury. Other risk factors include
recent a viral illness, respiratory infection, stress, fatigue, use of prescription
or nonprescription drugs including aspirin, and a history of allergies, smoking,
and alcohol use.
Please remember that the body wants to be in harmony: with all systems working
together to create balance.
The diagnostic tests will include MRI, EEG, Audiometry
Tests (Hearing) including Electronystagmography, Transtympanic
electrocochleography (ECOG)
For more description and an excellent overview, please go to
In your details, you will need to describe what happens when you have an
attack. It really helps to have this written down. Better still, give the doctor
a copy of your description.
He will need a history of the frequency, duration, severity, and character
of your attacks, the duration of hearing loss and whether it has been changing.
You will be asked if you have any history of:
- diabetes, high blood pressure, high blood cholesterol, thyroid, neurologic
or emotional disorders.
- tinnitus or fullness in either or both ears
- syphilis, mumps, or other serious infections in the past, inflammations
of the eye,
- auto-immune disorders or allergy, or
- ear surgery in the past.
A physical examination of the ears and other structures of the head
and neck will be done, but these findings are usually normal, except during
an attack.
Several other tests will be done. They include:
Magnetic Resonance Imaging "MRI"
This will be one of the first as it simply rules out any abnormal physical
conditions in your head.
It provides detailed pictures of brain and nerve tissues from multiple planes
without obstruction by overlying bone.
What will this test tell you? MRI is the procedure of choice for most
brain disorders because it can clearly show various types of nerve tissue. It
provides clear pictures. It is noninvasive and can evaluate blood flow and the
flow of cerebrospinal fluid (CSF). An MRI can distinguish tumors or other lesions
from normal tissues. MRI is sometimes used to avoid the dangers of repeated
exposure to radiation
How the test is performed The MRI scanner is in an area that has been
shielded from outside magnetic fields. You lie on a narrow table that can slide
inside a large tunnel-like tube within the scanner. The scanner creates a magnetic
field around you, then directs radio waves at the tissues in question. Several
sets of images are usually required, each taking from 2 to 15 minutes. The complete
scan takes about 1 hour; some scans take more than 90 minutes. This test will
not cause any discomfort.
Electroencephalogram "EEG"
What will this test tell you? It helps to diagnose the presence and type
of seizure disorders, confusion, head injuries, brain tumors, infections, degenerative
diseases, and metabolic disturbances that all could affect the brain. Incidentally
the procedure cannot be used to "read the mind," measure intelligence, or diagnose
mental illness.
How the test is performed. It will be done by an specially-trained technician
in a room designed for this purpose only. It may be in an office or in a hospital
setting. You will be asked to lie on your back on the table or to sit in a reclining
chair. Many flat metal discs (electrodes) will be placed in different positions
on your scalp. (They are held in place with a sticky paste.) These electrodes
are connected by wires to an amplifier and a recording machine. The recording
machine converts the electrical signals into a series of wavy lines. (Like an
ECG.) These are then shown on a monitor and can be printed out. Because any
movement can alter the results, you will need to lie very still with your eyes
closed. You may be asked to do certain things during the recording, such as
breathe deeply and rapidly for several minutes or look at a very bright flickering
light. (It will be OK to move during these requests.) This test is without discomfort.
Hearing Tests: Audiometry/Audiology
What will this test tell you?
These measure hearing ability. There are several different ones. Each is
done for a specific purpose.
An audiometric examination typically indicates a sensory type of hearing
loss in the affected ear. With Meniere's Disease the ability to distinguish
"sit" and "fit" is often diminished in the affected ear. (Speech discrimination)
Audiometry is particularly helpful in making the diagnosis of Ménières
syndrome. This can determine and measure low frequency or mixed low and high
frequency, "Pike's Peak" pattern. When trying to make a diagnosis of Ménières,
iIt is very helpful to have precise documentation of fluctuating hearing loss.
How the test is performed
Audiography provides a more precise measurement of hearing. Air conduction
is tested by having you wear earphones attached to the audiometer. Pure tones
of controlled intensity are delivered, usually to one ear at a time. You are
asked to indicate (by raising a hand, pressing a button, or other means) when
they hear a sound, and the minimum intensity (volume) required to hear each
tone is graphed. An attachment is placed against the bone behind each ear to
test bone conduction.
Transtympanic electrocochleography (ECOG)
Each ear is tested separately. One teaspoon of cold water is gently instilled
in the ear canal with a bulb syringe. This should cause nystagmus (quick
movement of both eyes away from the direction of ice water and then slowly back).
If it does not cause nystagmus, 2 teaspoons of cold water are instilled in the
ear canal. If nystagmus still fails to occur, 4 and then 8 teaspoons of cold
water are used.
At times, hot water may be used in addition to cold water. The nystagmus
should occur in the opposite direction (toward the hot water then slowly away).
Use of both cold water and hot water makes the test more accurate.
For more in-depth information on these critical
tests please visit:
Diagnostic Tests For Meniere's Disease Symptoms
This is an in depth article on the
types of testing done to look for and diagnose Meniere's Disease. This
should help you understand interpret Meniere's Disease testing, your body and
its functions. If you have a medical problem, please seek appropriate advice.
American Academy of Otolaryngology - Head and Neck Surgery