Meniere's disease is a disorder of the inner ear of unknown cause. It is characterised by excessive pressure and progressive dilation of the endolymphatic system. It is more common in middle-aged adults but may be seen at any age. Meniere's disease has a similar prevalence in both men and women.


  • Incidence: 15.00 cases per 100,000 person-years
  • Peak incidence: 40-50 years
  • Sex ratio: 1:1
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+

Clinical features

  • recurrent episodes of vertigo, tinnitus and hearing loss (sensorineural). Vertigo is usually the prominent symptom
  • a sensation of aural fullness or pressure is now recognised as being common
  • other features include nystagmus and a positive Romberg test
  • episodes last minutes to hours
  • typically symptoms are unilateral but bilateral symptoms may develop after a number of years


  • ENT assessment is required to confirm the diagnosis
  • patients should inform the DVLA. The current advice is to cease driving until satisfactory control of symptoms is achieved
  • acute attacks: buccal or intramuscular prochlorperazine. Admission is sometimes required
  • prevention: betahistine and vestibular rehabilitation exercises may be of benefit


Natural history
  • symptoms resolve in the majority of patients after 5-10 years
  • the majority of patients will be left with a degree of hearing loss
  • psychological distress is common