Most readers are familiar with the American Academy diagnostic criteria for Ménière’s disease (MD) but a significant minority will be aware of other criteria from Japan and Korea. This new effort is a collaboration between these three bodies and the Barany Society, as part of the latter’s attempt to classify vestibular disorders (ICVD), making the criteria truly international. There are only two categories: definite and probable MD. Definite MD is characterised by a) two or more spontaneous episodes of vertigo each lasting 20 minutes to 12 hours, b) audiometrically documented low to medium frequency sensorineural hearing loss in one ear, defining the affected ear on at least one occasion before, during or after one of the episodes of vertigo, c) fluctuating aural symptoms (hearing, tinnitus or fullness) in the affected ear, d) not better accounted for by another vestibular diagnosis. Probable MD is defined as: a) two or more episodes of vertigo or dizziness, each lasting 20 minutes to 24 hours, b) fluctuating aural symptoms (hearing, tinnitus or fullness) in the affected ear, c) not better accounted for by another vestibular diagnosis.
Of note, documented hearing loss is no longer a requirement for probable MD.
The authors make a distinction between vertigo (the sensation of self-motion when no self-motion is occurring or the sensation of distorted self-motion during an otherwise normal head movement) and dizziness as defined by International Classification of Vestibular Disorders (ICVD). Key differential diagnosis such as vestibular migraine, autosomal dominant low frequency sensorineural hearing loss, TIA and autoimmume inner ear disease are addressed in this paper. It is worth a read.
