Meniere’s disease diagnosis

If you think you may have Meniere’s disease, a physician will be able to test you and make a diagnosis. Because the symptoms of Meniere’s overlap with other disorders and conditions, it’s important to visit a physician who specializes in ear disorders and can rule out any other causes. An otolaryngologist, a doctor who focuses on disorders of the ear, nose, and throat, would be a good choice. Your physician will start by consulting your medical history and getting a complete account of your symptoms. They may then use a variety of hearing and balance tests to determine whether your symptoms are due to Meniere’s disease^[9]:

• Hearing Test (audiometry): Meniere’s tends to affect your ability to hear higher- and lower-frequency sounds, with the midrange relatively unchanged. A hearing test will show how well you perceive different sounds at different pitches and how easily you can tell the difference between two similar sounds. This can help your doctor tell whether your hearing loss matches that of a Meniere’s patient^[10].
• Electrocochleography: Electrocochleography is a more intensive hearing test that can help determine how your auditory nerves respond to sound. Your doctor attaches electrodes to your head and inserts a probe into your ear. You will then be played a series of loud clicks while the probe and electrodes measure your nerve activity^[11]. This test can also measure the fluid pressure of the inner ear. Higher-than-normal pressure may indicate excessive endolymph.
• Balance Test (Electronystagmography [ENG] and videonystagmography [VNG]): A balance test can help determine whether your visual and balance systems are in sync. Your doctor will have you sit in a chair and focus on light patterns on a screen while moving your body. Meanwhile, special goggles will record your eye movements. Next, warm or cool water will be placed in your ears, which should cause your eye muscles to react in a predictable way. If they don’t, it may indicate a problem with your inner ear consistent with Meniere’s^[12].
• Rotary-Chair Test: Similar to an ENG or VNG test, this exam uses a computer-controlled swivel chair to stimulate your inner ear while goggles record your eye movements^[13].
• Posturography: This test can help determine which types of inputs you rely on most for balance: signals from your inner ear, vision, or signals from your muscles and skin. It can also indicate whether your vertigo stems from one of these inputs. You stand barefoot on a movable platform while wearing a safety harness and attempt to keep your balance as it shifts.

If these tests are inconclusive, your doctor may recommend more intensive testing, like Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scans. This can help rule out the possibility that other disorders or underlying conditions are causing your symptoms rather than Meniere’s.