Diagnosis

Your doctor will conduct an exam and take a medical history. A diagnosis of Meniere's disease requires:

• Two episodes of vertigo, each lasting 20 minutes or longer but not longer than 12 hours
• Hearing loss verified by a hearing test
• Tinnitus or a feeling of fullness in your ear
• Exclusion of other known causes of these problems

Hearing assessment

A hearing test (audiometry) assesses how well you detect sounds at different pitches and volumes and how well you distinguish between similar-sounding words. People with Meniere's disease typically have problems hearing low frequencies or combined high and low frequencies with normal hearing in the midrange frequencies.

Balance assessment

Between episodes of vertigo, the sense of balance returns to normal for most people with Meniere's disease. But you might have some ongoing balance problems.

Tests that assess function of the inner ear include:

• Videonystagmography (VNG). This test evaluates balance function by assessing eye movement. Balance-related sensors in the inner ear are linked to muscles that control eye movement. This connection enables you to move your head while keeping your eyes focused on a point.
• Rotary-chair testing. Like a VNG, this measures inner ear function based on eye movement. You sit in a computer-controlled rotating chair, which stimulates your inner ear.
• Vestibular evoked myogenic potentials (VEMP) testing. This test shows promise for not only diagnosing, but also monitoring Meniere's disease. It shows characteristic changes in the affected ears of people with Meniere's disease.
• Posturography. This computerized test reveals which part of the balance system — vision, inner ear function, or sensations from the skin, muscles, tendons and joints — you rely on the most and which parts may cause problems. While wearing a safety harness, you stand in bare feet on a platform and keep your balance under various conditions.
• Video head impulse test (vHIT). This newer test uses video to measure eye reactions to abrupt movement. While you focus on a point, your head is turned quickly and unpredictably. If your eyes move off the target when your head is turned, you have an abnormal reflex.
• Electrocochleography (ECoG). This test looks at the inner ear in response to sounds. It might help to determine if there is an abnormal buildup of fluid in the inner ear, but isn't specific for Meniere's disease.

Tests to rule out other conditions

Blood tests and imaging scans such as an MRI may be used to rule out disorders that can cause problems similar to those of Meniere's disease, such as a tumor in the brain or multiple sclerosis.