Which symptoms comprise the classic triad of Menière disease?

• A. Episodic vertigo, fluctuating hearing loss, tinnitus
• B. Chronic dizziness with constant hearing loss
• C. Vertigo accompanying fever and ear pain
• D. Hearing loss with no vertigo

Answer: (A)

Menière disease is defined by a distinctive cluster of symptoms that tend to come and go together. The classic triad consists of recurrent episodes of vertigo (a spinning sensation), fluctuating sensorineural hearing loss (often starting in the low frequencies and changing between episodes), and tinnitus (often with a sensation of fullness in the ear). These features reflect the underlying problem in the inner ear called endolymphatic hydrops, which causes both the vertigo attacks and the fluctuating hearing loss, with tinnitus accompanying the hearing changes.

The other options don’t fit this pattern: vertigo with fever and ear pain points to an infectious or inflammatory process rather than Ménière’s; hearing loss without vertigo misses the defining episodic vertigo; and chronic dizziness with constant hearing loss lacks the fluctuating, episodic nature characteristic of Ménière's disease.