Four symptoms must usually be identified in order to receive a classic Meniere's diagnosis:
vertigo, tinnitus, fullness of the ear and a measurable amount of deafness. At differing stages of Meniere's, particularly the early stages, not all of these are significantly present and often a small amount of tinnitus or imbalance may be ignored by the individual feeling medical advice unnecessary.
For those seeking help in early stages a deferred or alternative diagnosis may be likely although doctors usually suggest a low salt diet anyway. Occasionally a doctor may diagnose a case of atypical Meniere's when the classic symptoms are not all presented. Should all the classic symptoms be presented, diagnosis will be easier and more likely once other conditions have been excluded.
Classic symptoms of Meniere's disease in detail
FULLNESS OF EAR
LOSS OF HEARING
VERTIGO - episodic
Vertigo it is the sensation of movement when movement is not actually occurring. In severe vertigo, your surroundings appear to be moving horizontally or vertically or often in Meniere's, in the form of fast spinning. Less severe sensations may be that of being rocked to-and-fro, back and forth. Closing the eyes and the individual feels as though they are being rotated. The sensations can be slight and only just noticeable, or the feeling is so intense that you are being pulled with force and fall to the ground. Vertigo can be very frightening and distressing, especially when occurring for the very first few times. It is not the same as dizziness which is more associated with a light headed feeling.
Most people will need to lie down, trying to focus on one object to bring their world to a stand still. Others may be continuously be vomiting in response to the sensation of movement.
Attacks of vertigo are not usually predictable but many sufferers say that they have increases in tinnitus, ear fullness and loss of hearing immediately before. The body's reaction to vertigo often means you are also sweating and experiencing rushes of adrenaline or the sensation of panic or palpitations. Attacks
may occur every day, once or twice a week, or as few as once a year. For some their attacks come in clusters or even "brief shocks"- the attacks usually last longest earlier on, this can be even as much as 24 hours, there are no ground rules
on this one. Some people go for years without vertigo and consider themselves in remission or burn out. After an attack of vertigo many people feel exhausted and need to sleep.
Vertigo tends to reduce as
the disease progresses. On average 50% of people are vertigo free after 2 years, and 71% are usually vertigo free by year 8. Others continue to experience attacks for up to 20 years. Otolithic crisis of Tumarkin is the name given to a vertigo attack causing you to drop to the floor, or drop attack which are often present early on in the disease or for some the later stages. You feel as though a magnificent force is pulling you to the floor and you cannot stop it, but you do not lose consiousness.
Vertigo is usually the reason people seek medical advice, and as it is the most debilitating symptom, it is the main reason for surgical intervention (when medicines and diet changes are not effective).
TINNITUS - constant but fluctuating
Ringing, whistling, roaring or some noise that seems to come from one/both
ears or from within the head. Usually in unilateral Meniere's only the affected ear will have tinnitus. This can be very stressful and disturbing
especially when in quiet environments as the tinnitus will be more prominent! For some the loudness
increases, or the pitch changes prior to an attack of vertigo. Tinnitus continues event after vertigo ceases / burn out. Click here to listen to an example of tinnitus.
FULLNESS OF THE EAR - fluctuates, usually worse prior to vertigo attack
A sensation of pressure which can be compared to changes in altitude e.g. if you were coming down in an aero plane
- however gulping and yawning does not clear it in Meniere's and the pressure is usually far more intense than that experienced in altitude changes. It can be very uncomfortable and will fluctuate in intensity and often worsens prior to a vertigo attack. Fullness continues event after vertigo ceases / burn out. Many people report fullness in both ears even when only one ear is the Meniere's ear.
DEAFNESS & LOSS OF HEARING - fluctuates and worsens as the disease progresses
A fluctuating deafness, eventually leading to total deafness in related
ear. Often this will start with hearing loss of low frequency tones, expanding to eventual complete deafness. Many people experience difficulty talking in crowded rooms as they cannot single out a voice in a noisy environment, sometimes directional hearing is affected, e.g. a noise occurs but you can't decipher which direction the noise came from. For some hyperacusis is part of the damaged hearing.
HYPERACUSIS - episodic
Not considered to be one of the four classic symptoms but more part of hearing problems. Hyperacusis is a sensitivity to sounds - e.g. a dogs bark, a child's scream, a dropped saucepan which normally tolerable but a nuisance, will now cause great sharp pain
in your ear! The silliest noise one day you suddenly cannot tolerate, while the next is fine. Loud or agrevating sounds can trigger the sense of vertigo.
DIZZINESS / IMBALANCE - episodic, permanent
A loss of balance and perception of the world- for some this comes and
goes for days, weeks, months or it is permanently about. The kind
of dizzy sensation felt is not like that as is understood by a healthy
person. The word "spells" is so often coupled with dizzy. "Oh she is having a dizzy spell." This implies a short period. However in reality the imbalance is 24/7 in varying intensities.
The sensation of "about to go dizzy" or that the room is about to spin, but it doesn't actually happen is quite common. Balance in the dark and poorly lit areas can be quite problematic.
I have talked to many other sufferers, and with my father we belong to
the British Meniere's Society.
It would seem that Meniere's sufferers and people with balance problems often have other complications in addition
to the classic one's listed here. I was moved to draw up a list of these so that others could gain reassurance, and over the years found huge numbers of people confirming they also have other
symptoms and problems
This web site has been written and developed by Alex Tye - "MrLexy" on the internet!
http://www.mrlexy.co.uk. Please feel free to contact me with my feedback form.