Vestibular conditions are wildly heterogenous, and diagnosis is based on symptom grouping along with test results, but test results can vary wildly and don't have nearly as much consistency across populations as you'd think. Add to this that most ENTs are just terrible and don't know much of the details of vestibular diagnosis, and don't even have a consistent fact-set about these disorders (that is, each ENT "knows" some fact that completely contradicts what another ENT "knows"). At this point I've taken to printing out a diagnostic guide by a very high-level expert to bring to doctors so they can read it. There are literally "junk bag" diagnoses/condition names that exist solely for when the patient's symptoms and tests don't fit well into one of the more common diagnoses Sorry, but that seems to be the state of ENTs and diagnosis for vestibular conditions
Hello EAOfficial, Wouldn't it be appropriate for most countries to adopt the diagnostic criteria outlined in the AAO-HNS 2020 guidelines? This includes a significant average Pure Tone Average (PTA) decrease of 10 dB HL or at least a 15% decline in word recognition ability, alongside symptoms such as ear pressure, dizziness, hearing loss, and tinnitus. Previously, the AAO-HNS considered the average of 4 Pure Tone thresholds, but since 2020, they have revised it to only include 3 frequencies at 500, 1000, and 2000 Hz to determine the average loss. While it is important to rule out other conditions before diagnosing Meniere's disease, meeting all the criteria mentioned above may indicate a definitive diagnosis of Meniere's. I am curious if there are other potentially more modern criteria being used by some, but as of now, I am only aware of these as the officially recognized ones.
Well, I was talking about harder cases, of which there are plenty, and I am one. I would call them atypical symptoms but with vestibular conditions it represents a HUGE cohort that I would guesstimate is 20 - 40% of vestibular patients. And then there's the issue that the doctors also refuse to recognize certain basic things, such as the utility of antivirals as long-term prophylactic. I even saw one post on a forum where one patient said his ENT said "No, Valium is only for anxiety" !!! Plenty of doctors also refuse to recognize the value of betahistine
My primary care physician, and I like him a LOT--he's ben my doc for over 25 years put me on an off label use for Nortriptyline, an antidepressant, but even that was ok as it worked great until it didn't and I had a 6 out of 10 episode of vertigo yesterday. (10 being a drop attack where my butt hits the floor.) What stood out to me was as he was reviewing the ENT report, etc. he said "I was reading an article..." and then he prescribed the Nortriptyline. Great. He read an article probably just before my appointment. ANYWAY, it was then I asked for a got a referral to a specialist. I really hope he doesn't come in and say "I was just reading an article...)
Greetings to everyone. As I am currently undergoing diagnostic procedures, I would like to share that my previous mentioned method of self-administering audiograms during episodes of vertigo or hearing impairment has proven to be highly beneficial. Recently, I consulted with a specialist in Meniere's disease who reviewed the audiograms and indicated a possible diagnosis of bilateral Meniere's disease. Although he wanted to rule out other potential conditions such as autoimmune disorders, additional blood tests have been requested to further investigate. The preliminary blood test results have returned normal. I anticipate receiving a formal diagnosis during my next appointment. I hope that sharing my experience may assist others in expediting their diagnostic journey.
Hi Steven I first used an app in combination with a headphone certified for this task. I noticed that my first ent wasn’t bothered about the results and so I was able to put my hands on an official machine. Although the results are identical this opened the door to meet a specialist on Meniere and now I am almost there. by the way it’s not only the graph they are interested in but also the average loss on 500, 1000 and 2000 hz. If this number rapidly changes and or the word recognition change more then 15% the change is higher to get the definite Meniere diagnosis. If you are interested I can share the official criteria most countries seem to use.