Meniere Disease Symptoms: Spinning Dizziness, Ear Ringing and When to Be Seen

What it involves

MedlinePlus explains that Meniere's disease is a disorder of the inner ear that can cause severe dizziness, a roaring sound in the ears called tinnitus, hearing loss that comes and goes, and a feeling of ear pressure or pain. It usually affects just one ear. Scientists do not yet know the cause, and think it has to do with fluid levels in the canals of the inner ear.

Who this is for

• Adults with attacks of spinning dizziness that come and go.
• Patients with ringing or roaring in one ear and hearing that fluctuates.
• People who feel ear fullness or pressure along with dizziness.
• Anyone who has fallen or nearly fallen during a dizzy spell.

What to expect

• Questions about how long attacks last, hearing changes, ear ringing, falls, medicines and salt intake
• An exam of the ears, eye movements, balance and nerves, plus blood pressure
• Blood work, which the practice offers, when other causes of dizziness need to be checked
• A referral for a hearing test and an ear, nose and throat or hearing specialist

Rule out a stroke first

Sudden dizziness is not always an ear problem. Dizziness with drooping of the face, weakness in an arm or leg, trouble speaking, double vision, a sudden severe headache or loss of balance with no warning can be a stroke, and that needs a 911 call, as the stroke warning signs guide explains. A first-ever severe attack is worth urgent evaluation even when the ear is the likely cause. Fainting is covered separately in the fainting guide.

What it can feel like

MedlinePlus says attacks of dizziness may come on suddenly or after a short period of tinnitus or muffled hearing. Some people have a single attack once in a while, while others have many attacks close together over several days. Some have drop attacks, where the dizziness is so bad they lose their balance and fall. Because falls are a risk, clear walkways and sit down at the first sign of an attack. The balance problems guide covers fall prevention.

How it differs from other dizziness

Several things cause spinning. Brief spells triggered by head position are usually inner-ear crystals, covered in the vertigo guide. Lightheadedness when standing is another matter, discussed in the dizziness guide, and the low blood pressure guide. Meniere disease stands out because the ear symptoms come with the dizziness. The tinnitus guide and the hearing loss guide cover those symptoms on their own.

How it is diagnosed

According to MedlinePlus, doctors diagnose it based on a physical exam and your symptoms, and a hearing test can check how it has affected your hearing. The practice does not do hearing tests in the office, so that step is by referral. Wax can block the ear and add to the muffled feeling, which the earwax blockage guide explains, and an ear infection can mimic some symptoms, as the ear pain guide describes.

Treatment and daily life

MedlinePlus says there is no cure. Treatments include medicines to control dizziness, limiting salt in the diet and taking water pills, and a device that fits into the outer ear and delivers air pulses to the middle ear may help. Severe cases may require surgery. A primary care provider can start the plan and coordinate with an ear specialist. Do not drive during an attack, and ask before changing medicines. The salt advice ties in with the hypertension management page.

When to be seen quickly

Make an appointment for repeated spinning spells, hearing that comes and goes, or ear ringing in one ear. Be seen the same day for a sudden drop in hearing in one ear or a first severe attack that does not settle. Call 911 for stroke signs, chest pain, fainting or a fall with a head injury. Same-day visits and walk-ins are welcome, and the sick visit versus urgent care or ER guide can help you choose.

Sources

• MedlinePlus: Meniere's Disease