In Meniere's disease, the diagnostic criteria per the 2015 Barany Society guidelines require which of the following for a definite diagnosis (as opposed to probable)?
- A Two or more spontaneous vertigo episodes ≥20 minutes + CT temporal bone showing endolymphatic sac pathology
- B One vertigo episode ≥20 minutes + audiometrically confirmed SNHL + tinnitus
- C Vertigo + unilateral SNHL + response to intratympanic gentamicin
- D Two or more spontaneous vertigo episodes ≥20 minutes + audiometrically confirmed low-to-mid frequency SNHL + fluctuating aural symptoms + not better explained by another diagnosis ✓
Explanation
The 2015 Barany Society/AAO-HNS criteria for definite Meniere's disease require all of: (1) two or more spontaneous vestibular episodes of vertigo lasting 20 minutes to 12 hours; (2) low-to-medium frequency sensorineural hearing loss on audiometry in the affected ear at least at one time point; (3) fluctuating aural symptoms (hearing, tinnitus, or fullness) in the affected ear; and (4) not better accounted for by another vestibular diagnosis. 'Probable' Meniere's requires the same vertigo criterion but with only subjective fluctuating aural symptoms (without audiometric confirmation). CT temporal bone is not a diagnostic criterion. Response to treatment is not a diagnostic criterion.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
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Written and medically reviewed by the StethoPrep medical team.