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Getting a diagnosis for Menieres Disease is notoriously difficult and is often a source of great frustration for Menieres sufferers.
The diagnosis is almost always made by the ENT Consultant and will generally not be given until all other potential issues have been ruled out. This is because there is no accepted precise diagnosis for Menieres Disease and hence it is a judgement factor based on all known symptoms and lack of any evidence of other issues. The process of getting a diagnosis from an ENT Consultant can sometimes take years if the symptoms and testing are not clear.
It is generally accepted that Meniere’s disease symptoms are as a result of inflammation of the endolymphatic sac within the inner ear.
For reference, the current traditional existing approach to diagnosis within the medical profession is outlined below.
This the criteria for Meniere’s Disease diagnosis as agreed by the Barany Society in 2015.
This diagnostic criteria for Meniere’s was reformulated in 2015 as per the figure above by the Classification Committee of the Barany Society, the Korean balance Society, the Japan Society for Equilibrium Research, the European Academy of Otology and Neurotology and the Equilibriam Committee of the Americam Academy of Autolaryngology – Head and Neck Surgery.
Not all doctors accept the 2015 agreement, many probably don’t even know of it.
Therefore the current standard diagnosis tests will usually include hearing testing (audiometry), an ENG test, a VEMP test, several blood tests (ANA, FTA), and an MRI scan of the head. Newer variants of MRI are currently an emerging technology for diagnosis. Electrocochleography (ECochG) is often helpful, although it remains controversial. As aural fullness can be caused by eustachian tube malfunction, tympanometry is sometimes useful.
A first step would generally be for your GP and/or ENT Consultant to have completed their normal testing and discounted other contributory factors not Meniere’s related through MRI scan, blood tests etc.
The absence of other factors and conformation with the above Barany Society guidelines should lead to a diagnosis of Menieres Disease from your ENT Consultant
Diagnosing with other related conditions
Chronic inflammation lies at the heart of most chronic illnesses and Menieres Disease seems no different. Addressing the underlying causes of this chronic inflammation has the potential to reduce your Meniere’s symptoms.
Sufferers often do not have one symptom only or one sole cause for their symptoms. They often have an overlapping set of medical problems which need addressing.
The above table can be used as a guide to indicate potential symptoms, other potential chronic conditions Menieres sufferers often have and the additional tests which could be performed to diagnose the root cause of these .
A good approach would be to get copies of all your medical records so you can review the scope of your testing so far and determine how best to proceed. See what tests have not been performed and which treatments have not yet been tried.
We’ve found that for chronic illness symptoms like those listed above a consultation with a qualified Functional Medical Practitioner would be beneficial in helping find the root cause of your Menieres. You can find an appropriate local Practitioner by using the search facility of the website of the Institute for Functional Medicine
A Functional Practitioner will take an holistic view to help you find the root cause of your Menieres which can then lead to a subsequent specific treatment pathway to reduce inflammation within your body, relieve the load on the immune system and lead to improved control of Meniere’s symptoms.
The journey for all of us generally starts with a visit to your Doctor after experiencing some type of hearing or balance issues or a vertigo attack.
Photograph below is one of my very first hearing tests showing the typical low frequency hearing loss in my left ear which is consistent with a diagnosis of Menieres Disease.
This is the standard hearing test performed by your Doctor or ENT Consultant. It’s called an audiogram. The image above shows the classic Menieres display of “low frequency hearing loss” in the left ear. The right ear is perfectly normal.
Here is an example of an audiogram of familiar sounds to show where they sit on the high and low frequency scale e.g. birds singing, pneumatic drill
Hearing loss is measured in decibels (dB HL) and displayed in a graph format called an audiogram. Loudness is plotted from the top (soft) to bottom (loud) on the “y” axis. Frequency (pitch) is plotted from left (bass) to right (treble) on the “x” axis. Hearing loss is not measured in percentage, but rather in degree as follows:
|Normal Hearing||0 – 25 dB HL|
|Mild Hearing Loss||26 – 40 dB HL|
|Moderate Hearing Loss||41 – 70 dB HL|
|Severe Hearing Loss||71 – 90 dB HL|
|Profound Hearing Loss||91+ dB HL|