Ménière’s disease may result from overproduction or decreased absorption of endolymph, which causes endolymphatic hydrops or endolymphatic hypertension, with consequent degeneration of the vestibular and cochlear hair cells.

This condition may stem from autonomic nervous system dysfunction that produces a temporary constriction of blood vessels supplying the inner ear. In some women, premenstrual edema may precipitate attacks of Ménière’s disease.

Ménière’s disease produces three characteristic effects: severe vertigo, tinnitus, and sensorineural hearing loss. Fullness or blocked feeling in the ear is also quite common. Violent paroxysmal attacks last from 10 minutes to several hours. During an acute attack, other signs and symptoms include severe nausea, vomiting, sweating, giddiness, and nystagmus. Also, vertigo may cause loss of balance and falling to the affected side.

To lessen these signs and symptoms, the patient may assume a characteristic posture—lying on the unaffected ear
and looking in the direction of the affected ear. Initially, the patient may be asymptomatic between attacks, except for residual tinnitus that worsens during an attack.