The Four Basic Symptoms Needed for a Beginning Diagnosis of Meniere’s Disease
Two episodes of vertigo, each lasting 20 minutes or longer than 12 hours.
Hearing loss verified by a hearing test.
Tinnitus-ringing in the ears
Aural Fullness-feeling of fullness in your ear.
Exclusion of other known causes of these problems -Mayo Clinic
Progression of symptoms
Common symptoms of a Ménière’s disease attack do not reflect the entire picture of the disorder, because symptoms vary before, during, between, and after attacks, and also during the late-stage of Ménière’s disease.
Ménière’s disease may start with fluctuating hearing loss, eventually progressing to attacks of vertigo and dizziness.
Oncoming attacks are often preceded by an “aura,” or the specific set of warning symptoms, listed below. Paying attention to these warning symptoms can allow a person to move to a safe or more comfortable situation before an attack.
- balance disturbance
- dizziness, lightheadedness
- headache, increased ear pressure
- hearing loss or tinnitus increase
- sound sensitivity
- vague feeling of uneasiness
During an attack of early-stage Ménière’s disease, symptoms include:
- spontaneous, violent vertigo
- fluctuating hearing loss
- ear fullness (aural fullness) and/or tinnitus
In addition to the above main symptoms, attacks can also include:
- anxiety, fear
- blurry vision or eye jerking
- nausea and vomiting
- cold sweat, palpitations or rapid pulse
Following the attack, a period of extreme fatigue or exhaustion often occurs, prompting the need for hours of sleep.
The periods between attacks are symptom free for some people and symptomatic for others. Many symptoms have been reported after and between attacks:
- anger, anxiety, fear, worry
- appetite change
- concentration difficulty, distractibility, tendency to grope for words
- fatigue, malaise, sleepiness
- headache, heavy head sensation
- lightheadedness (faintness)
- loss of self-confidence and self-reliance
- nausea, queasiness, motion sickness
- neck ache or stiff neck
- palpitations or rapid pulse, cold sweat
- sound distortion and sensitivity
- unsteadiness (sudden falls, staggering or stumbling, difficulty turning or walking in poorly lit areas, tendency to look down or to grope for stable handholds)
- vision difficulties (problems with blurring, bouncing, depth perception, glare intensification, focusing, watching movement; difficulty looking through lenses such as binoculars or cameras)
Late-stage Ménière’s disease refers to a set of symptoms rather than a point in time. Hearing loss is more significant and is less likely to fluctuate. Tinnitus and/or aural fullness may be stronger and more constant. Attacks of vertigo may be replaced by more constant struggles with vision and balance, including difficulty walking in the dark and occasional sudden loss of balance. Sometimes, drop attacks of vestibular origin (Tumarkin’s otolithic crisis3) occur in this stage of Ménière’s disease and are characterized by sudden brief loss of posture without loss of consciousness. Some of these late-stage symptoms can become more problematic in conditions of low lighting, or with fatigue, or when a person is exposed to visually stimulating situations.