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Clinical diagnosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Meniere's disease is a clinical diagnosis. Patients usually present with episodic dizziness.

  • acute episodes of vertigo should be differentiated from non-rotatory dizziness
    • ask the question "did you just feel lightheaded or did you see the world spin around as though you just got off a playground roundabout?

      • no - then could be presyncope, lightheadedness, and disequilibrium in elderly people

      • yes - rule out "red flags" suggesting brainstem stroke or other central signs, do confirmatory test to rule out other common causes of vertigo

        • Hallpike manoeuvre - for benign positional vertigo, head thrust test - for acute vestibular neuritis

        • if both are negative consider
          • vestibular migraine - if vertigo plus migraine is recurrent
          • Meniere's disease - transient unilateral hearing loss or tinnitus, and previous episodes of dizziness


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