Quick Answer
Meniere's disease causes recurrent vertigo attacks with hearing loss and tinnitus — typically in one ear. It's manageable with the right treatment.
Medically reviewed by Dr. Jitendra Prasad Yadav • NMC 8029 • Kathmandu Neurology Clinic & Cognitive Center
Meniere's disease is an inner ear disorder causing episodic attacks of vertigo (spinning dizziness lasting 20 minutes to 12+ hours), fluctuating hearing loss, tinnitus (ringing) and ear fullness — usually in one ear. The exact cause is unknown but involves abnormal fluid pressure in the inner ear (endolymphatic hydrops).
Symptoms of an attack
Sudden severe vertigo with nausea/vomiting, fluctuating low-frequency hearing loss (worse during/after attacks), tinnitus, and ear fullness/pressure. Attacks are unpredictable and can be disabling. Hearing typically recovers between attacks initially but may permanently decline over years.
Diagnosis
Clinical criteria: ≥2 spontaneous vertigo episodes lasting 20 min–12 hours, audiometrically documented low- to medium-frequency hearing loss in one ear, fluctuating aural symptoms, and exclusion of other causes. MRI rules out acoustic neuroma.
Treatment
Acute: vestibular suppressants and antiemetics during attacks. Preventive: low-salt diet, diuretics, betahistine (evidence mixed). Intratympanic steroids or gentamicin injections for refractory cases. Meniett device (pressure pulses). Surgical options (endolymphatic sac decompression, vestibular neurectomy) for severe refractory disease.
When to seek professional evaluation
Meniere's disease is distinguished from other vertigo causes at vestibular evaluation — because treatment differs from BPPV and vestibular migraine.
This guide is educational and does not replace individual medical advice.
Frequently asked questions
Answers reviewed by Dr. Jitendra Prasad Yadav • MBBS, MD (Internal Medicine), FICN (Neurology), FCNV, FIHM • NMC 8029
Vertigo is a subtype of dizziness; other forms include lightheadedness and imbalance, each suggesting different causes.
BPPV (Benign Paroxysmal Positional Vertigo) causes brief spinning with head movement. Positional maneuvers performed by a healthcare provider are often effective.
Migraine is a neurological condition; headache is one feature. Associated symptoms and functional impact are important for diagnosis.
Aura refers to visual, sensory, or speech symptoms that precede the headache in some people. Both types are migraine; the presence of aura may influence management discussion.
Vertigo is spinning. Dizziness is broader — lightheaded, faint, unsteady. Vertigo often indicates vestibular dysfunction (inner ear or brain) and is typically triggered by head position change, while lightheadedness often reflects blood pressure, dehydration, or medication effects. Duration and triggers guide evaluatio…
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References & Review
Reviewed by Dr. Jitendra Prasad Yadav • Last reviewed: 2026-11-10
- International Classification of Headache Disorders, 3rd edition (ICHD-3).
- Harrison's Principles of Internal Medicine — Neurology sections.
- American Academy of Neurology guidelines for selected conditions (where applicable).
Content is educational and aligns with standard medical references; individual evaluation may vary. External links provide context and do not imply endorsement.