Screening for Menière's disease in the general population - the needle in the haystack

Acta Otolaryngol. 2008 Mar;128(3):272-6. doi: 10.1080/00016480701509933.

Abstract

Conclusion: Based on clinical history alone, 98.4% of the population with vestibular vertigo do not qualify for a diagnosis of Menière's disease (MD). Although frequent in dizziness clinics, MD is rare in the general population.

Objective: To narrow down the prevalence of MD in the general population.

Subjects and methods: A representative sample adult population sample (n=4869) was screened for moderate or severe dizziness/vertigo. Subsequently, 1003 participants completed a validated neurotologic telephone interview on vestibular vertigo (VV). Prevalence of MD was determined by stepwise application of clinical criteria according to the AAO (1995): (1) at least two vertigo attacks of > or =20 min duration, (2) unilateral hearing loss, and (3) accompanying cochlear symptoms.

Results: Lifetime prevalence of VV was 7.4%. Of 243 participants with VV, 51 (21%) had recurrent vertigo lasting > or =20 min. Of these, nine reported unilateral hearing loss, and four had accompanying cochlear symptoms (1.6% of VV patients, population prevalence 0.12%).

MeSH terms

  • Aged
  • Cross-Sectional Studies
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Hearing Loss, Unilateral / diagnosis
  • Hearing Loss, Unilateral / epidemiology
  • Humans
  • Male
  • Mass Screening*
  • Medical History Taking
  • Meniere Disease / diagnosis*
  • Meniere Disease / epidemiology
  • Middle Aged
  • Tinnitus / diagnosis
  • Tinnitus / epidemiology