Classifications of Meniere’s Disease

Jessie J, a popular British pop singer, shared that she was diagnosed with Meniere’s disease (MD) after waking up Christmas Eve morning with hearing loss in her right ear and vertigo.

She reported in her Instagram live feed that it felt like her right ear was “completely deaf” and that she “couldn’t walk a straight line.”

In a recent interview, she reported feeling fortunate to access care immediately and receive “proper” treatment. Her specific treatment was not disclosed in either interview or Instagram feed.>

The diagnostic criteria for MD was revised in 2015 through a joint effort of the Classification Committee of the Bárány Society, The Japanese Society for Equilibrium Research, the European Academy of Otology and Neurotology (EAONO), the Equilibrium Committee of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), and the Korean Balance Society.

They describe two classifications, Definite MD and Probable MD. According to the new diagnostic consensus statement:

Definite Meniere’s must meet the following criteria:

Two or more spontaneous episodes of vertigo each lasting 20 minutes to 12 hours
Audiometrically documented low- to medium frequency sensorineural hearing loss in one ear, defining the affected ear on at least one occasion before, during or after one of the episodes of vertigo
Fluctuating aural symptoms (hearing, tinnitus, or fullness) in the affected ear
Not better accounted for by another vestibular diagnosis

Probable MD must meet the following criteria:

Two or more episodes of vertigo or dizziness, each lasting 20 minutes to 24 hours
Fluctuating aural symptoms (hearing, tinnitus, or fullness) in the affected ear
Not better accounted for by another vestibular diagnosis (Lopez-Escamez, Carey, Chung et al, 2015)

Other diagnoses to be considered in the differential include (Lopez-Escamez, Carey, Chung et al, 2015):

Autoimmune inner ear disease
Cerebrovascular disease (stroke/TIA in the vertebrobasilar system/bleeding)
Cogan‘s syndrome
Endolymphatic sac tumor
Meningiomas and other masses of the cerebellopontine angle
Neuroborreliosis
Otosyphilis>
Susac syndrome
Third window syndromes
Vestibular migraine
Vestibular paroxysmia (neurovascular compression syndrome)
Vestibular schwannoma
Vogt-Koyanagi-Harada syndrome

References

Tschinkel A. (2020) Jessie J diagnosed with Meniere’s DiseaseShape. December 19

Lopez-Escamez JA et al. (2015) Classification Committee of the Barany Society; Japan Society for Equilibrium Research; European Academy of Otology and Neurotology (EAONO); Equilibrium Committee of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS); Korean Balance Society. Diagnostic criteria for Menière’s disease. J Vestib Res25(1):1-7.