Which description best characterizes Menière disease?

• A. Peripheral vertigo with episodic vertigo, fluctuating hearing loss, tinnitus
• B. Central vertigo with gait ataxia
• C. Vertigo with persistent muffled hearing loss only
• D. Central vertigo with constant vertical nystagmus

Answer: (A)

Menière disease is a peripheral inner-ear disorder driven by abnormal fluid (endolymphatic hydrops) in the labyrinth. The hallmark is vertigo that comes in episodes, paired with fluctuating sensorineural hearing loss and tinnitus, often with a sense of fullness in the affected ear. Because the problem lies in the inner ear, the vertigo is peripheral rather than central, and the hearing loss tends to fluctuate rather than be a constant, purely muffled loss. This combination of episodic vertigo, fluctuating hearing loss, and tinnitus is what sets Menière apart from central causes of vertigo or a persistent hearing impairment without the characteristic episodic vertigo.