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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Assessment online. A doctor can assess attacks of vertigo by video and help you manage a confirmed diagnosis; hearing tests, the diagnosis and specialist treatment are in person.
- What it is: a long-term inner ear condition that causes attacks of spinning vertigo with hearing loss, ringing (tinnitus) and a feeling of fullness, usually in one ear.
- Attacks: the spinning usually lasts 20 minutes to 12 hours, rarely more than 24 hours, and attacks often become less frequent over time.
- Who gets it: most often adults aged 40 to 60. It usually affects one ear, but both ears are affected in 15 to 25% of people.
- Emergency: call 112 for spinning with facial drooping, weakness or numbness in an arm or leg, slurred speech, double vision or sudden loss of vision. These can be signs of a stroke.
Do not book a video appointment if your dizziness comes with facial drooping, weakness, numbness or tingling in an arm or leg, slurred speech, double vision or loss of vision, or if you are so off balance that you cannot stand: call 112 or go to an emergency department, and do not drive yourself. A first attack with sudden hearing loss also needs urgent assessment: get medical advice the same day.
Can an online doctor help with Ménière’s disease?
Not fully. Ménière’s disease is diagnosed in person, with hearing tests, balance tests and often an MRI scan, usually by an ear, nose and throat (ENT) specialist, and treatments such as injections into the ear or surgery are given in person. What a doctor can do by video is go through your attacks, tell you whether they fit Ménière’s disease or point to something else, rule out the signs of a stroke and of sudden hearing loss, help with medicine for attacks when it is safe, and support you between specialist visits.
How an online consultation helps with Ménière’s disease
- Ménière’s, or something else?: Labyrinthitis, migraine and positional vertigo also cause spinning, and the pattern of your attacks helps tell them apart.
- Emergencies ruled out first: Stroke signs and sudden hearing loss are checked before anything else, and you are sent to the right care if either is likely.
- A plan for attacks: What to do when the spinning starts, and medicine for the sickness and the spinning when it suits you.
- Life between attacks: Salt, caffeine and alcohol, driving, work and heights, and which specialist tests to ask for.
What the doctor checks in an online assessment for Ménière’s disease
The doctor asks about the warning signs first, then about the pattern of your attacks. The doctor asks about:
- Warning signs: facial drooping, weakness or numbness, slurred speech, double vision, a severe headache, sudden hearing loss, or being unable to stand.
- The attacks: how they start, how long the spinning lasts, how often they come, and whether anything sets them off.
- Your ears: hearing loss, ringing, fullness or pressure, which ear, and whether the hearing comes back between attacks.
- Other causes: migraine, recent colds or flu, spinning that comes only when you move your head, and new medicines.
- Your health: autoimmune conditions, Ménière’s disease in the family, pregnancy, and the medicines you take.
- Daily life: falls, driving, work, sleep, and how worried or low the attacks make you feel.
Before the call, write down the date and length of your recent attacks and what came with them. Have any hearing test, scan or specialist letters to hand.
What is Ménière’s disease?
Ménière’s disease is a long-term condition of the inner ear, the part that controls hearing and balance. It causes attacks of spinning vertigo with hearing loss, tinnitus and a feeling of fullness in the ear. It cannot be cured, but treatment helps the symptoms, and many people live full, active lives.
The exact cause is not known. The symptoms are linked to a build-up of fluid, called endolymph, in the inner ear (endolymphatic hydrops), but it is not clear why the fluid builds up, or whether it causes the symptoms. Possible contributors include poor drainage of the fluid, autoimmune conditions such as rheumatoid arthritis and lupus, viral infections, allergies, and genes: Ménière’s disease can run in families.
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| Fact | What the sources say |
|---|---|
| Usual age at the start | 40 to 60, although it can start at any age; it is rare under 18 |
| Men or women | Affected equally |
| One ear or both | Usually one ear; both ears in 15 to 25% of people |
| Length of an attack | Usually 20 minutes to 12 hours, rarely more than 24 hours |
| How many people | In the United States, about 615,000 people have it, and about 45,500 are diagnosed each year |
| Over the years | Attacks often become less frequent, but hearing may get worse and tinnitus may become constant |
What are the four symptoms of Ménière’s disease?
The four main symptoms are spinning vertigo, hearing loss, ringing in the ear (tinnitus), and a feeling of pressure or fullness in the ear. They come in attacks, start suddenly, and can occur alone or together:
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| Symptom | What it feels like | Over time |
|---|---|---|
| Vertigo | A spinning feeling that starts and stops suddenly, often without warning, often with feeling or being sick | Attacks often become less frequent |
| Hearing loss | Muffled hearing in the affected ear, worse during an attack and often better between attacks | Can become worse and permanent |
| Tinnitus | Ringing, buzzing, roaring, whistling or hissing in the affected ear | Can become constant |
| Fullness | Pressure, discomfort or pain deep inside the ear | Comes and goes with attacks |
An attack can start without warning, or after a short spell of ringing or muffled hearing. Some people have single attacks months apart; others have several over a few days. Between attacks, hearing often recovers, at least in the early years.
Drop attacks
Some people have attacks of vertigo so severe that they lose their balance and fall, called drop attacks. Falls and injuries are a real risk with Ménière’s disease, which is why safety at home, at work and when driving matters.
Ménière’s disease or something else?
Vertigo is a symptom, not a diagnosis, and inner ear problems are its most common cause. The length of the spinning, what sets it off and what comes with it are the best clues:
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| Condition | What points to it | Read more |
|---|---|---|
| Ménière’s disease | Repeated attacks of 20 minutes to 12 hours, with hearing loss, ringing and fullness in one ear | This page |
| Labyrinthitis and vestibular neuritis | One long episode that starts suddenly, often after a cold or flu, and eases over days to weeks; hearing is affected only in labyrinthitis | Labyrinthitis |
| Positional vertigo (BPPV) | Spinning brought on by particular head movements | BPPV |
| Vestibular migraine | Dizziness or vertigo in someone who gets migraines | Vestibular migraine |
| Sudden hearing loss | Hearing that drops all at once or over a few days, sometimes with dizziness or ringing | Hearing loss: urgent |
| Stroke | Spinning with facial drooping, weakness, numbness, slurred speech or double vision | Call 112 |
Some medicines list vertigo as a side effect, so check the leaflets of anything you started recently. Ringing on its own is covered on the tinnitus page.
How is Ménière’s disease diagnosed?
There is no single test. An ENT specialist makes the diagnosis from your symptoms, a hearing test and tests that rule out other conditions. The diagnosis is definite when all of these apply:
- two or more attacks of spinning vertigo, each lasting 20 minutes to 12 hours
- hearing loss in the low to middle pitches, shown on a hearing test before, during or after an attack
- hearing loss, tinnitus or fullness in the affected ear that comes and goes
- no other balance condition that explains the symptoms better
When everything fits except the hearing test, the diagnosis is called probable Ménière’s disease. Balance tests check how the inner ear is working, and an MRI or CT scan rules out other causes, such as a benign growth on the balance nerve or multiple sclerosis. A family doctor usually starts by looking in the ears, examining the head and neck and testing your balance, for example by asking you to stand with your heels together and your eyes closed.
A diary of your attacks, with the date, how long the spinning lasted and what came with it, is one of the most useful things you can bring to the specialist.
What triggers Ménière’s attacks, and what should you avoid eating?
What sets off an attack is not fully understood. The advice from specialists focuses on things that may affect the fluid in the inner ear, although the evidence behind diet changes is limited:
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| Step | What it means in practice |
|---|---|
| Less salt | A low-salt diet, discussed with your doctor; a US government guide suggests limiting salt to 1,500 to 2,000 mg a day |
| Less caffeine | Cut down on coffee, tea, cola and chocolate |
| Less alcohol, no smoking | Avoid alcohol where you can, and stop smoking |
| Fewer foods with added MSG | Some specialists advise limiting monosodium glutamate |
| Fluids | Drink plenty of fluids through the day |
| Stress | Relaxation, breathing exercises, mindfulness or talking therapy, as stress may play a part |
There is no evidence that acupuncture, acupressure, tai chi or supplements such as ginkgo biloba, niacin or ginger root help Ménière’s disease.
What might the doctor recommend for Ménière’s disease?
What happens next depends on whether this is a first attack, whether the diagnosis has been confirmed, and how the attacks affect you. This is the framework the doctors use:
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| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Spinning with facial drooping, weakness, slurred speech or double vision | Emergency care | No | Call 112 now |
| A first attack with sudden hearing loss | Urgent assessment and a hearing test | Only to assess | Urgently: get medical advice the same day |
| Repeated attacks of vertigo with ear symptoms, no diagnosis yet | Assessment, a plan for attacks, and referral for hearing tests | Yes, to assess | For hearing and balance tests and an ENT specialist |
| Confirmed Ménière’s disease, attacks as usual | Self-care during attacks, and medicine for sickness or spinning when needed | Yes | If attacks change, become more frequent or cause falls |
| Attacks that are not controlled | Review of lifestyle steps and medicines, and a specialist referral | Partly | For injections into the ear, a pressure device, grommets or surgery |
| Constant tinnitus or worsening hearing | Hearing test and support | Partly | For hearing aids and tinnitus therapy |
Not sure whether your dizziness is Ménière’s disease? A doctor can tell you in one consultation what it is likely to be and what to do next.
See available times →How is Ménière’s disease treated?
Treatment aims to make attacks less frequent and less severe and to protect your hearing and balance. Specialists usually start with the simplest steps and move on only if attacks continue:
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| Treatment | What it does | Good to know |
|---|---|---|
| Medicines during an attack | Anti-sickness medicines and vestibular sedatives ease the spinning and sickness | Work best when taken early in an attack |
| Diet, lifestyle and stress steps | Less salt, caffeine and alcohol, and managing stress | Evidence is limited, but they are low risk |
| Betahistine tablets | Increases the effect of histamine in the inner ear, aiming to reduce attacks | Widely prescribed, but a large trial found it no better than a placebo at reducing attacks |
| Diuretics (water tablets) | Aim to reduce fluid in the inner ear | Used alongside a low-salt diet |
| Vestibular rehabilitation | Balance exercises with a physiotherapist or audiologist | Helps balance problems between attacks |
| Steroid injections through the eardrum | Reduce inflammation in the inner ear | Little or no risk to hearing |
| Pressure-pulse device or grommets | Gentle air pressure pulses, or a small tube in the eardrum | Grommets are the least invasive surgical step |
| Gentamicin injections through the eardrum | Stop the balance part of the inner ear working | Control vertigo, but carry a real risk of hearing loss, so are used when hearing is already poor |
| Surgery | Endolymphatic sac surgery, cutting the balance nerve, or removing the balance organ | For severe attacks that other treatment has not helped; removing the balance organ only when hearing is very poor |
What you can do yourself
- During an attack, sit or lie down somewhere safe straight away, keep your head still, and lie in a quiet, dark room if you can.
- Sip fluids if you are being sick, and get up slowly once the spinning has passed.
- Keep your attack medicine with you at all times.
- Try a low-salt diet, and cut down on caffeine and alcohol. Do not smoke.
- Keep a diary of attacks to share with your doctor.
- Think about safety before climbing ladders, swimming or using machinery, and do not swim alone.
Prescription treatment
A prescription is never issued without a consultation. For attacks, the doctor may prescribe an anti-sickness medicine or a vestibular sedative, such as an antihistamine, to take for a few days at a time. Long-term treatments, such as betahistine, diuretics and steroid or gentamicin injections, are usually started or reviewed by an ENT specialist after the diagnosis is confirmed. Benzodiazepines and other controlled medicines are never prescribed online. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Supplements, acupuncture and other alternative therapies, which have no evidence behind them. Assuming that every new dizzy spell is Ménière’s disease: a change in the pattern needs a doctor. Driving while attacks can still come without warning.
Living with Ménière’s disease: special situations
Driving
Do not drive while you are dizzy, when an attack is starting, or while attacks can come without warning. Tell the authority that issued your driving licence, and ask your doctor when it is safe to drive again: in the UK, the DVLA must be told about dizziness that comes on suddenly or happens often, and driving can restart once symptoms are under control.
Work, heights and swimming
Ladders, heights, swimming and dangerous machinery carry extra risk if an attack could start. Plan around them, and tell your employer if your job involves them. At home, keep stairs and floors free of things you could trip over.
Hearing and tinnitus
Hearing aids help hearing loss that stays, and tinnitus therapy helps ringing that becomes constant. The hearing loss and tinnitus pages cover both.
Anxiety and low mood
Not knowing when the next attack will come causes worry, stress and anxiety for many people. Counselling and breathing exercises can help, and the anxiety page covers what a doctor can do.
Pregnancy
Tell the doctor if you are pregnant or breastfeeding, because it changes which medicines are suitable for attacks.
Ménière’s disease while travelling in Europe
Carry your attack medicines in your hand luggage, with a copy of your diagnosis and the names of your medicines. If an attack comes with any of the warning signs below, call 112 wherever you are.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When Ménière’s disease is assessed online, and when you need in-person care
Assessed online: attacks of vertigo that could be Ménière’s disease, ruling out other causes, a plan and medicine for attacks when it is safe, lifestyle advice, and support between specialist visits.
In-person care: the diagnosis, hearing and balance tests, MRI scans, injections into the ear, grommets and surgery, and any attack with the signs of a stroke or sudden hearing loss.
When to get in-person care
Call 112 or go to an emergency department now for:
- spinning with facial drooping, or being unable to lift both arms and keep them up
- spinning with slurred or garbled speech, double vision or sudden loss of vision
- weakness, numbness or tingling in an arm or leg
- feeling so off balance that you cannot stand or walk
- someone who cannot be woken up
Get medical advice the same day for:
- sudden hearing loss in one or both ears, including in a first attack
- vertigo with a severe headache, repeated vomiting or a very high temperature
- a fall or injury during an attack
- attacks that are suddenly much more frequent or different from usual
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about your attacks: say how long the spinning lasts, how often it comes, and what happens to your hearing, and mention any diagnosis or tests you already have.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s Ménière’s disease? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Labyrinthitis can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about Ménière’s disease
What is Ménière’s disease?
Ménière’s disease is a long-term condition of the inner ear that causes attacks of spinning vertigo with hearing loss, ringing in the ear and a feeling of fullness, usually in one ear. It is linked to a build-up of fluid in the inner ear, and it most often starts between the ages of 40 and 60.
What are the four symptoms of Ménière’s disease?
The four symptoms of Ménière’s disease are spinning vertigo, hearing loss, ringing or buzzing in the ear (tinnitus), and a feeling of pressure or fullness in the ear. They come in attacks, and the spinning usually lasts 20 minutes to 12 hours.
What triggers Ménière’s disease?
The cause of Ménière’s disease is not fully known. It is linked to fluid build-up in the inner ear, and autoimmune conditions, viral infections, allergies and genes may play a part. Many attacks have no clear trigger, but salt, caffeine, alcohol and stress are commonly advised against.
What foods should I avoid with Ménière’s disease?
With Ménière’s disease, specialists often advise less salt, less caffeine in coffee, tea, cola and chocolate, less alcohol, and fewer foods with added monosodium glutamate, with plenty of fluids. The evidence is limited, but these steps are low risk.
What should I do during a Ménière’s attack?
Sit or lie down at once, somewhere safe, and keep your head still, with your eyes on a fixed point or closed; do not try to drive or walk about. Take the anti-sickness or vertigo medicine your doctor has prescribed for Ménière’s attacks as soon as the spinning starts, sip water if you can, and wait, since the spinning usually passes within hours. Call 112 if the dizziness comes with facial drooping, weakness, slurred speech or double vision.
Is there a cure for Ménière’s disease?
No. Ménière’s disease cannot be cured, but treatment can make attacks less frequent and easier to cope with, and attacks often become less frequent over the years. Claims that a supplement or an alternative therapy cures it are not backed by evidence.
How is Ménière’s disease diagnosed?
Ménière’s disease is diagnosed by an ear specialist, from two or more attacks of vertigo lasting 20 minutes to 12 hours, hearing loss shown on a hearing test, and ear symptoms that come and go, after other causes have been ruled out, often with an MRI scan.
Does Ménière’s disease go away?
Ménière’s disease is usually lifelong, but attacks often become less frequent over time. Hearing loss can get worse and become permanent, and tinnitus can become constant, which hearing aids and tinnitus therapy can help.
Is Ménière’s disease hereditary?
It can run in families: having a close relative with Ménière’s disease raises the risk. Autoimmune conditions, viral infections and allergies may also play a part.
Can you drive with Ménière’s disease?
Not while Ménière’s attacks can come without warning. Do not drive when you are dizzy or an attack is starting, and tell the authority that issued your licence. Driving can usually restart once symptoms are under control.
Does betahistine work for Ménière’s disease?
It is widely prescribed, but the evidence is weak. A review of studies of vertigo from different causes found only low-certainty evidence of benefit, and a large trial in Ménière’s disease found that it did not reduce attacks more than a placebo. It is usually started or reviewed by an ENT specialist.
When is dizziness an emergency?
Dizziness is an emergency, whether or not you have Ménière’s disease, when it comes with signs of a stroke: a drooping face, weakness or numbness of an arm or leg, slurred speech, double vision or sudden loss of vision, a severe headache unlike any before, or being unable to stand or walk. Call 112 for any of these, and for dizziness with chest pain or fainting; a typical Ménière’s attack, however unpleasant, settles within hours.
Can an online doctor help with Ménière’s disease?
Partly. A doctor can assess attacks of vertigo that could be Ménière’s disease by video, rule out emergencies, help with medicine for attacks and support you between specialist visits. The diagnosis, hearing tests and specialist treatment are in person.
- Ménière’s disease, NHS, National Health Service (UK), reviewed 11 September 2026.
- Ménière’s disease, NIDCD, US National Institute on Deafness and Other Communication Disorders, updated 15 August 2024.
- Meniere’s disease: symptoms and causes, Mayo Clinic (US), 2026.
- Meniere’s disease, ENT UK, patient information, published 31 October 2025.
- Efficacy and safety of betahistine treatment in patients with Meniere’s disease: primary results of a long term, multicentre, double blind, randomised, placebo controlled, dose defining trial (BEMED trial), Adrion C, et al. BMJ, 2016.
- Betahistine for symptoms of vertigo, Murdin L, Hussain K, Schilder AGM. Cochrane Database of Systematic Reviews, 2016.
- Vertigo, NHS, National Health Service (UK), reviewed 2 May 2023.
- Labyrinthitis and vestibular neuritis, NHS, National Health Service (UK), reviewed 6 August 2026.
- Sudden deafness, NIDCD, US National Institute on Deafness and Other Communication Disorders, updated September 2018.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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