I appreciate you taking the time to write all that out—it’s clear you’ve been through the medical wringer yourself and are trying to spare someone else the same anxiety spiral. You’re giving a very balanced, experience-based perspective, and a lot of what you said is spot-on, so I’m going to expand on it, annotate it, and throw in everything else that’s commonly in the differential for “new-onset wobbliness/dizziness at age 43” so the person reading this has the most complete picture possible without having to hop from forum to forum.
Classic Ménière’s disease (what you had)
You nailed the tetrad:
Episodic vertigo (usually 20 min to 12 h, severe, bed-spinning)
Low-frequency sensorineural hearing loss (fluctuating at first, eventually permanent)
Tinnitus (roaring or blowing quality)
Aural fullness
The natural history you described is real: a subset of people (maybe 10–20 %) have a monophasic course where attacks cluster for 6–24 months and then burn out, leaving some residual low-frequency loss and maybe mild imbalance between attacks. Most people, unfortunately, keep having attacks for decades unless they get ablative treatment (gentamicin, labyrinthectomy, etc.). You got lucky.
Key point for anyone reading: if the vertigo is truly mild “wobbliness” and there is zero tinnitus/fullness/fluctuating hearing loss, Ménière’s drops way down the list.
Vestibular migraine (now the #1 cause of recurrent dizziness in most ENT/Neuro practices)
Can start at any age, huge peak in 30s–50s
Dizziness can be anything from rocking/ swaying/ floating to full-blown spinning
Episodes last minutes to 72 h (much more variable than Ménière’s)
30–50 % of patients never get the headache part, or the headache is mild
Motion sensitivity, visual vertigo (grocery-store aisles, scrolling screens), photophobia, and phonophobia are huge clues
Family history of migraine is common
Triggers: stress, sleep deprivation, certain foods, hormonal shifts, barometric pressure changes
Diagnosis is clinical; MRI is clean
Treatable with diet (low tyramine), lifestyle, and prophylactic meds (venlafaxine, nortriptyline, topiramate, propranolol, etc.)—very high response rate
This is the thing most people have never heard of and the thing that gets misdiagnosed as “atypical Ménière’s” for years.
Persistent Postural-Perceptual Dizziness (PPPD, or 3PD)
Chronic non-spinning dizziness (>3 months), usually described as rocking, swaying, “drunk,” or “walking on pillows”
Worse upright, better lying down
Exquisitely sensitive to complex visual environments and self-motion
Almost always triggered by a preceding event: vestibular neuritis, BPPV attack, panic attack, migraine, concussion, even a bad flu
The brain basically “learns” to over-rely on visual and somatosensory input and never re-calibrates
Very treatable with SSRI/SNRI + vestibular rehab + cognitive-behavioral therapy
BPPV (benign paroxysmal positional vertigo)
Usually brief spinning (seconds) brought on by head position changes
Can present as vague imbalance if the attacks are tiny or if posterior canal is not the affected canal (horizontal canal BPPV gives more swaying than spinning)
Epley or BBQ roll fixes 85–90 % in one visit
Vestibular neuritis / labyrinthitis
One big hit of vertigo lasting days, then residual wobbliness for weeks–months
Head impulse test abnormal toward the bad side, often some hearing loss if labyrinthitis
Steroids in the first few days help recovery; otherwise time + rehab
Superior canal dehiscence (SCDS, Third Window syndrome)
Autophony (hearing your own voice/eye movements/heartbeat in the affected ear)
Dizziness triggered by loud sounds (Tullio), straining, coughing, or pressure changes
Low-frequency air-bone gaps on audiogram that look conductive but are pseudo-conductive
CT temporal bone with 0.625 mm cuts or less shows the dehiscence
Surgical plugging or capping fixes it if severe
Mal de Débarquement Syndrome (MdDS)
Rocking/swaying that starts after a boat/plane/train trip and never goes away
Worse when still, paradoxically better when in motion (driving)
Bilateral vestibular loss
Oscillopsia (world bouncing when walking or riding in car) + imbalance in the dark
Causes: gentamicin ototoxicity, autoimmune inner-ear, CANVAS syndrome, superficial siderosis, etc.
Cerebellar / brainstem causes (the scary ones)
Acoustic neuroma (vestibular schwannoma): usually very slowly progressive unilateral hearing loss + tinnitus + imbalance; sudden vertigo is rare unless it hemorrhages
Chiari malformation: valsalva-induced headache/dizziness, downbeating nystagmus
Posterior fossa tumors (medulloblastoma, ependymoma, hemangioblastoma, metastasis): morning headache, vomiting, gait ataxia, cranial nerve signs
Multiple sclerosis: internuclear ophthalmoplegia, other signs
Vertebrobasilar insufficiency / stroke: other brainstem signs, usually acute and devastating
At age 43 with isolated wobbliness and no red flags (headache, diplopia, dysarthria, weakness, numbness, bowel/bladder issues), the chance of a brain tumor or MS causing only mild dizziness approaches lottery-ticket levels. The data say >95 % of new dizziness in this age group is peripheral (inner ear or vestibular nerve).
Red flags that should make you go to ER or neuro same-week
New headache (“worst of life” or thunderclap)
Double vision, facial numbness/weakness, slurred speech, limb weakness
Vertical nystagmus (especially downbeating)
Gait so bad you can’t walk heel-to-toe without falling
Central-type nystagmus on exam (gaze-evoked bidirectional, pure torsional, etc.)
Practical next steps (in order)
See primary doc → get basic labs (CBC, chemistries, TSH, B12, maybe HbA1c)
Referral to the right specialist:
If any suspicion of central cause → neurologist (preferably one who does vestibular testing)
Otherwise → otoneurologist or neurotologist (an ENT fellowship-trained in advanced ear/balance disorders). Avoid plain audiologist unless you just want a hearing test.
Testing you’ll probably get:
Comprehensive audiogram (looking for low-frequency loss or asymmetry)
VNG/ENG with calorics and positional testing
vHIT (video head impulse test)
Cervical and ocular VEMP (helps diagnose SCDS)
MRI IAC with/without contrast (rules out schwannoma and most central causes)
Possibly posturography or rotary chair if bilateral loss suspected
Bottom line (tl;dr of the tl;dr)
At 43 with new mild wobbliness and no other neurologic symptoms, the odds are overwhelmingly in favor of something peripheral and treatable—vestibular migraine and PPPD together account for the majority of these presentations in most specialty practices. Ménière’s is possible but unlikely without the full symptom cluster. Brain tumor/MS/stroke are dramatic on MRI and usually announce themselves with more than just “I feel a little off balance.”
Get the right specialist (neurotologist > neurologist > general ENT > audiologist), expect a few thousand dollars of testing, and in 6–12 months you’ll probably be laughing about how worried you were.
And yes, praise God when it turns out to be benign and self-limited, which it almost certainly will be.
The eyymologies are my favorite part of your original post. You dropped some absolute gems, but you also left a few doors cracked open that deserve to be flung wide. Let’s go full philological nerd on every term you mentioned and then some. Buckle in; this will be obscenely long.
1. Audiologist ← audire (Latin) “to hear”
Perfect. The root shows up everywhere:
audio, auditory, audition (theater sense = “hearing a performance”), audience (literally “those who hear”), auditor (the church or royal official who “heard” accounts), audible, obedience (ob-audire = “to hear toward” → listen carefully), and even oboe (haut-bois → “high wood,” but the -oe spelling was influenced by folk etymology with audire in French). Extra credit: the -ence ending in audience/obedience is the same one in “intelligence” (inter-legere), “elegance” (e-legere), etc.—all nouns of action.
2. ENT = Ear-Nose-Throat doctor = otorhinolaryngologist
You beautifully broke this down, but let’s savor every syllable:
oto- ← οὖς (genitive ὠτός) “ear” → otoscope, otitis, otic, otorrhea, parotid (παρά + οὖς = “beside the ear”), mastoid (μαστός “breast” + -oeidēs “shaped like” because the mastoid process looks like a tit), zygoma (ζυγώμα “yoke,” because it yokes the temporal bone to the rest of the face).
rhino- ← ῥίς (genitive ῥινός) “nose” → rhinoceros (ῥινόκερως “nose-horned”), rhinoplasty, rhinitis, rhinovirus (it infects the nose), rhinolalia (nosey speech), rhinorrhea (“nose-run” = runny nose). Bonus Greek compound: rhinotillexomania = compulsive nose-picking (tillexis “plucking” + mania).
laryngo- ← λάρυγξ “larynx, upper windpipe” → larynx, laryngitis, laryngoscope, laryngectomy. The Greek word itself is pre-Greek, probably from a Mediterranean substrate (same layer as ἄλαγξ “valley,” because the larynx is a “hollow”). English “larynx” is a 16th-century New Latin coinage that feels like it should be Greek but isn’t quite.
-logist from λόγος (lógos) → this is the big one. In medical compounds -logist means “one who studies/treats the organ named.” But lógos itself is the most overloaded word in Greek: word, speech, reason, argument, story, computation, proportion, principle (Heraclitus), the Word (John 1:1). So technically an otorhinolaryngologist is “one who studies the rational principle of ear-nose-throat,” which is unintentionally poetic.
The full Greek spelling would be ὠτορρινολαρυγγολογιστής (ōtorhinolaryngologistēs). The English spelling with “ph” instead of “rh” (otopharyngologist is a rare variant) is a hypercorrection—people saw “pharynx” and thought “ph” belonged everywhere.
3. The “log-” that “makes little sense in modern English”
You’re right that it feels weird now, but historically it’s perfect. In medical Greek, -λογία (-logía) means “the study of” (cardiologia, dermatologia, etc.), and -λόγος (-lógos) as the second element in a compound often means “one who deals with” (ψευδολόγος = liar, “false-speaker”). So a λογιστής is a practitioner of the -λογία. It’s exactly parallel to physiologist, psychologist, etc. The word has simply become opaque because we no longer learn Greek roots in school.
4. Ménière’s disease – Prosper Ménière (1799–1862)
French physician who in 1861 first said “hey, this vertigo + deafness syndrome is in the inner ear, not the brain.” The French pronunciation is roughly /me.njɛʁ/, but in English we’ve flattened it to /mɛnˈjɛərz/ or even /ˈmɛn.i.ərz/. The apostrophe-s is the French possessive, like Hodgkin’s lymphoma or Crohn’s disease.
5. Vertigo
Direct from Latin vertigo “a turning, dizziness,” from vertere “to turn” (versus, vertex, vertical, vertebra, convert, adverse, invertebrate, anniversary). The -igo ending makes abstract nouns of action (impetigo “attack,” vert-igo “turning-around-ness”). The same root gives us the medical term “objective vertigo” (room spinning) vs “subjective vertigo” (I’m spinning).
6. Tinnitus
Latin tinnitus “ringing, jingling,” from tinnire “to ring, tinkle.” Onomatopoeic, like tintinnabulation (the sound of bells—Poe borrowed it). Related to Greek σίζω (sízō) “hiss.”
7. Aural (vs oral)
Aural ← Latin auris “ear” (→ auricle, auricular). Unrelated to oral ← os (genitive oris) “mouth.” The similarity is pure coincidence, but it causes endless confusion in medical dictation (“aural temperature” vs “oral temperature”).
8. Vestibular
From Latin vestibulum “entrance hall, forecourt.” The inner-ear sense organs were named “vestibular” because they’re in the vestibule of the bony labyrinth (the entrance chamber before you get to the cochlea and semicircular canals). The same word gives us “vestibule train,” “vestibulology” (old term for balance disorders), and the vestibular nerve (CN VIII superior division).
9. Labyrinth
Greek λαβύρινθος, probably pre-Greek (Cretan). Mythical maze built by Daedalus. Anatomically perfect name: the inner ear is an insanely complex maze of tiny passages. Daedalus himself is from δαιδάλλω “to work cunningly.”
10. Semicircular canals
Semi- “half” + circularis “circular” + canalis “pipe, channel” (from canna “reed”). The Romans used canalis for aqueducts and gutters; we still have “canal” and “channel.”
11. Otolith (“ear-stone”)
ὠτο- + λίθος “stone.” The calcium-carbonate crystals (statoconia) that sit on the macula of the utricle and saccule. Same -lith in nephrolithiasis (kidney stones), otosclerosis (pathologic bone growth around the stapes), and lithotripsy (stone-busting with shock waves).
12. Endolymph & perilymph
Endo- “inside” + lymph (Latin lympha “clear water,” probably from Greek νύμφη “nymph” via Etruscan). Perilymph is the fluid “around” the membranous labyrinth; endolymph is the potassium-rich fluid inside it. The difference in ionic composition is what drives the hair-cell battery.
13. Nystagmus
Greek νυσταγμός “nodding, drowsiness,” from νυστάζω “to nod, be sleepy,” because sleepy people’s eyes drift and jerk back. Perfectly descriptive.
14. Caloric testing
Not “calorie” (heat unit). From Latin calidus “hot” via calere “to be warm” (the same root as cauldron, scald, and nonchalant—literally “not warm,” i.e., cool-headed). You irrigate the ear with warm or cold water to induce convection currents in the endolymph.
15. Epley maneuver
Named after John Epley, Oregon ENT who popularized the canalith repositioning procedure in the 1980s. He fought an uphill battle against skeptical colleagues for years. The maneuver is sometimes called the “liberatory maneuver” in French literature (Semont maneuver is a different one).
16. Esophagus (in your swallowing story)
Greek οἰσοφάγος “gullet,” from οἴσω (future of φέρω “to carry”) + -φάγος “eating.” Literally “that which carries what is eaten.” Beautifully functional name.
17. Manometry
Greek μάννος “thin, sparse” + -metry. No—actually from Greek μανο- (from βάρος “weight” via French manomètre) ← manos “sparse, rare” (think “manometer” measures pressure by how much a gas is “thinned out”). The esophageal manometry catheter is the stuff of nightmares.
I could go on for another 5,000 words (cochlea from κοχλίας “snail,” stapes from “stirrup,” incus “anvil,” malleus “hammer,” fenestra “window,” ampulla “flask,” cupula “little dome,” etc.), but I’ll stop here.
Your original etymological riff was not just correct—it was elegant. The only tiny quibble is that “log-” doesn’t make “little sense” in modern English; it makes perfect sense once you know it’s the same lógos that gave us logic, dialogue, and Logos. Medicine is basically Greek fan-fiction that never ended, and we’re all still living inside it.