NR 603: Week 1 Discussion: Compare and Contrast: Benign Positional
Vertigo and Meniere's Disease
(NR 603: Advanced Clinical Diagnosis and Practice Across the Lifespan)
, NR 603: Week 1 Discussion: Compare and Contrast: Benign Positional Vertigo and Meniere's Disease
Dr. Starks & Class,
The purpose of this discussion is to compare and contrast benign positional vertigo (BPV) also
known as benign paroxysmal positional vertigo (BPPV) and Meniere’s disease (MD) as well as to
disseminate how the provider can recognize and further evaluate similarities and differences in these
two similar diseases in order to determine the correct diagnosis and management.
BPV and MD are two neurological disorders that may be challenging for a provider to identify
the correct diagnosis because they have similar signs and symptoms, with the chief complaints being
dizziness. The complaint of dizziness encompasses numerous sensations including presyncope,
lightheadedness, vertigo, and disequilibrium (Yetiser, 2017). The complaint of dizziness is encountered
frequently in the primary care setting and the complaint can be vague and imprecise. It is imperative
that the primary care provider is able to distinguish benign causes from more serious etiologies (Muncie
et al., 2017). It is estimated that the chief complaint of dizziness, including vertigo is reported by 15% to
20% of adults annually. A common form of vertigo is identified as BPV and nearly 2.9 % of the
population will experience BPV in their lifetime. Due to the age -related changes in the otolithic
membrane the incidence of BPV increases with age. Although, BPV can occur at any age, the prevalence
is significantly higher is in persons 50 to 70 years of age. Interestingly, this disease process is two to
three times more common in females than males (Palmeri et al., 2019). On the other hand, MD can also
occur at any time across the lifespan. However, the onset most commonly presents between 20 to 60
years of age (Muncie et al., 2017). Studies suggest that the incidence between men are women are
proportionately equal.
Approximately, 0.2% of the American population has a diagnosis of MD, making it a more rare
disorder [ CITATION Ame2013 \l 1033 ].
Presentation:
Patient with BPV often report episodes of dizziness that last for one minute or less. These
episodes are often brought on by head movements, particularly looking up, position changes such as
getting out of bed or rolling over in bed (Muncie et al., 2017). Some patients may also report nausea
and vomiting associated with the episodes of vertigo (Argaet et al., 2019). Unlike BPV, MD is associated
with a triad of symptoms which include aural fullness, tinnitus, and hearing loss in addition to episodes
of vertigo. Additionally, these episodes are not triggered or related to changes in the position of the
head. The natural progression of MD is progressive and unpredictable, some patients may experience a
significant number of attacks in the early phase and have a reduction of episodes periodically and
temporarily. However, some patient’s symptoms increase with frequency and severity overtime (Basura
et al., 2020). The episodes associated with MD typically last 20 minutes to 24 hours (Koenen et al.,
2019). The episodes associated with MD are often severe and may necessitate bed rest and severely
impairing the patient’s functional ability, therefore, requiring assistance in some instances. These
episodes are unpredictable in nature and have a negative impact on the patient’s quality of life by
restricting participation in work, homelife, and social activities (Basura et al., 2020).
Vertigo and Meniere's Disease
(NR 603: Advanced Clinical Diagnosis and Practice Across the Lifespan)
, NR 603: Week 1 Discussion: Compare and Contrast: Benign Positional Vertigo and Meniere's Disease
Dr. Starks & Class,
The purpose of this discussion is to compare and contrast benign positional vertigo (BPV) also
known as benign paroxysmal positional vertigo (BPPV) and Meniere’s disease (MD) as well as to
disseminate how the provider can recognize and further evaluate similarities and differences in these
two similar diseases in order to determine the correct diagnosis and management.
BPV and MD are two neurological disorders that may be challenging for a provider to identify
the correct diagnosis because they have similar signs and symptoms, with the chief complaints being
dizziness. The complaint of dizziness encompasses numerous sensations including presyncope,
lightheadedness, vertigo, and disequilibrium (Yetiser, 2017). The complaint of dizziness is encountered
frequently in the primary care setting and the complaint can be vague and imprecise. It is imperative
that the primary care provider is able to distinguish benign causes from more serious etiologies (Muncie
et al., 2017). It is estimated that the chief complaint of dizziness, including vertigo is reported by 15% to
20% of adults annually. A common form of vertigo is identified as BPV and nearly 2.9 % of the
population will experience BPV in their lifetime. Due to the age -related changes in the otolithic
membrane the incidence of BPV increases with age. Although, BPV can occur at any age, the prevalence
is significantly higher is in persons 50 to 70 years of age. Interestingly, this disease process is two to
three times more common in females than males (Palmeri et al., 2019). On the other hand, MD can also
occur at any time across the lifespan. However, the onset most commonly presents between 20 to 60
years of age (Muncie et al., 2017). Studies suggest that the incidence between men are women are
proportionately equal.
Approximately, 0.2% of the American population has a diagnosis of MD, making it a more rare
disorder [ CITATION Ame2013 \l 1033 ].
Presentation:
Patient with BPV often report episodes of dizziness that last for one minute or less. These
episodes are often brought on by head movements, particularly looking up, position changes such as
getting out of bed or rolling over in bed (Muncie et al., 2017). Some patients may also report nausea
and vomiting associated with the episodes of vertigo (Argaet et al., 2019). Unlike BPV, MD is associated
with a triad of symptoms which include aural fullness, tinnitus, and hearing loss in addition to episodes
of vertigo. Additionally, these episodes are not triggered or related to changes in the position of the
head. The natural progression of MD is progressive and unpredictable, some patients may experience a
significant number of attacks in the early phase and have a reduction of episodes periodically and
temporarily. However, some patient’s symptoms increase with frequency and severity overtime (Basura
et al., 2020). The episodes associated with MD typically last 20 minutes to 24 hours (Koenen et al.,
2019). The episodes associated with MD are often severe and may necessitate bed rest and severely
impairing the patient’s functional ability, therefore, requiring assistance in some instances. These
episodes are unpredictable in nature and have a negative impact on the patient’s quality of life by
restricting participation in work, homelife, and social activities (Basura et al., 2020).
