Clinical Features

Meniere disease characteristically manifests as recurrent episodes of acute, unilateral symptoms that last from minutes to hours.

• Peripheral vertigo

• Tinnitus

• Asymmetric fluctuating sensorineural hearing loss (SNHL)

  • Low to mid-frequency hearing loss that progressively worsens with each episode

  • May progress to deafness over several years

  • Tuning fork tests [3]

    • Weber test: lateralization to the healthy ear

    • Rinne test: bilaterally positive

• Spontaneous horizontal or horizontal rotatory nystagmus

  • Seen in some patients during an acute episode of Meniere disease

  • The direction of nystagmus is variable and can change .

  • Can be supressed by visual fixation

• Nausea and vomiting

• Ear fullness

Triggers

• Definitive triggers of Meniere disease are not known to exist

Progression

• Episodes fluctuate in severity and typically last from 20 minutes to 12 hours

• Periods of remission between attacks vary from months to years.

• In 10–25% of patients, the disease becomes bilateral.