An Attempt to Classify the Primary Vertigos

Hinchcliffe, R.

doi:10.1017/s0022215100067803

Cited by 11 publications

(5 citation statements)

References 65 publications

(4 reference statements)

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“…The clinical criteria for diagnosing MD have undergone some evolution over time, although they have maintained a classification based on symptoms, which are often difficult to target. In 1967, Hinchcliffe [4] described the classic clinical picture, with a triad of spontaneous vertigo, hearing loss, and aural fullness/tinnitus, after excluding other causes (pathology of the middle ear, central nervous system, pharmacology, systemic diseases, among others); later on, some light forms of the disease were described, in which the clinical picture is not complete [5].…”

Section: Clinical Diagnostic Criteria Of MDmentioning

confidence: 99%

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Magnetic resonance imaging and Ménière’s disease—unavoidable alliance

et al. 2021

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Ménière's disease (MD) is a clinical syndrome characterized by recurrent episodes of spontaneous vertigo, unilateral fluctuating sensorineural hearing loss, tinnitus, and aural fullness. Endolymphatic hydrops is recognized as the pathophysiological substrate of the disease, having been demonstrated in anatomical pathological studies and more recently by magnetic resonance imaging (MRI). The current criteria of the disease, however, remain symptom based and do not include the demonstration of endolymphatic hydrops. The authors review MRI techniques and diagnostic criteria of endolymphatic hydrops and the role of MRI in MD is discussed.

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Section: Clinical Diagnostic Criteria Of MDmentioning

confidence: 99%

“…Fig 4. Schematic representation of the cochlear membranous labyrinth in the axial plane along the greater axis of modiolus (m), according to Nakashima, Barath and Bernaerts.…”

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confidence: 99%

Magnetic resonance imaging and Ménière’s disease—unavoidable alliance

et al. 2021

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“…In the diagnostic work up, mainly vertigo character and type, associated hearing loss and tinnitus or aural fullness are taken into consideration. Indeed, in a taxonomic investigation of patients with vertigo, after exclusion of neurological and middle ear conditions, head trauma and ototoxicity, Hinchcliffe [ 23 ] found that those with ‘classical’ Menière’s disease (meeting the ‘‘definite MD’ definition below) fell in a single nosological entity with all the other cases of vertigo. He later argued that MD included ‘formes frustes’, where the triad of symptoms is not complete [ 24 ].…”

Section: Diagnostic Criteria: Evolution Of the Current Criteria For Amentioning

confidence: 99%

What is Menière’s disease? A contemporary re-evaluation of endolymphatic hydrops

et al. 2016

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Menière’s disease is a chronic condition with a prevalence of 200–500 per 100,000 and characterized by episodic attacks of vertigo, fluctuating hearing loss, tinnitus, aural pressure and a progressive loss of audiovestibular functions. Over 150 years ago, Prosper Menière was the first to recognize the inner ear as the site of lesion for this clinical syndrome. Over 75 years ago, endolymphatic hydrops was discovered as the pathologic correlate of Menière’s disease. However, this pathologic finding could be ascertained only in post-mortem histologic studies. Due to this diagnostic dilemma and the variable manifestation of the various audiovestibular symptoms, diagnostic classification systems based on clinical findings have been repeatedly modified and have not been uniformly used in scientific publications on Menière’s disease. Furthermore, the higher level measures of impact on quality of life such as vitality and social participation have been neglected hitherto. Recent developments of high-resolution MR imaging of the inner ear have now enabled us to visualize in vivo endolymphatic hydrops in patients with suspected Menière’s disease. In this review, we summarize the existing knowledge from temporal bone histologic studies and from the emerging evidence on imaging-based evaluation of patients with suspected Menière’s disease. These indicate that endolymphatic hydrops is responsible not only for the full-blown clinical triad of simultaneous attacks of auditory and vestibular dysfunction, but also for other clinical presentations such as “vestibular” and “cochlear Menière’s disease”. As a consequence, we propose a new terminology which is based on symptomatic and imaging characteristics of these clinical entities to clarify and simplify their diagnostic classification.

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“…a taxonomic investigation of patients with vertigo, after the exclusion of neurological and middle ear conditions, head trauma and ototoxicity, Hinchcliffe 6 found that those with 'classical' Ménière's disease (meeting the 'probable' definition below) fell into a single nosological entity with all other cases of vertigo. He later argued that Ménière's disease included 'forms frustes', where the triad of symptoms is not complete.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Ménière's disease: a reappraisal supported by a variable latency of symptoms and the MRI visualisation of endolymphatic hydrops

et al. 2013

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ObjectivesTo evaluate the onset of vertigo, hearing loss and tinnitus in Ménière's disease and the associated endolymphatic hydrops (EH) of the inner ear.DesignMulticentre evaluation of three patient groups.SettingsDisease-specific symptoms were reviewed among referred patients in a tertiary referral hospital in Finland and in members of a Finnish Ménière Association in Finland. The MRI of a separate group of patients was undertaken in a tertiary referral centre in Japan.Participants340 patients were reviewed in the referral hospital along with 740 members of the Ménière Association. MRI was undertaken in 224 patients in Japan.Primary and secondary outcome measuresLatency and symptom development in Ménière's disease, and the appearance of EH of the inner ear in monosymptomatic patients and in Ménière's disease.ResultsThe mean age of the first symptom was 43.8 years, with 10% of the patients being older than 65 years. The time delay between hearing loss and vertigo was more than 5 years in 20% of the members and of the patients. Gadolinium-contrasted MRI demonstrated EH in 90% of the patients with Ménière's disease, in which 75% was bilateral among patients with unilateral symptoms. In monosymptomatic patients with vertigo, tinnitus or hearing loss; EH was demonstrated in 55–90% of the patients either in the cochlea and/or the vestibulum of the symptomatic ear.ConclusionsMénière's disease often shows bilateral EH and comprises a continuum from a monosymptomatic disease to the typical symptom complex of the disease. We suggest that a 3T MRI measurement should be carried out in patients with sensory-neural hearing loss, vertigo and tinnitus, 4 h after the intravenous injection of a gadolinium-contrast agent to verify the inner ear pathology. This may lead to a better management of the condition.

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An Attempt to Classify the Primary Vertigos

Cited by 11 publications

References 65 publications

Magnetic resonance imaging and Ménière’s disease—unavoidable alliance

Magnetic resonance imaging and Ménière’s disease—unavoidable alliance

What is Menière’s disease? A contemporary re-evaluation of endolymphatic hydrops

Ménière's disease: a reappraisal supported by a variable latency of symptoms and the MRI visualisation of endolymphatic hydrops

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