A reader asks:
How likely is it that someone could be diagnosed with both Benign Paroxysmal Positional Vertigo (BPPV) and Meniere’s Disease?
Actually, the question that our reader poses is somewhat different from the title of this post, which we worded. But let’s start with the title. We haven’t seen any authoritative studies on the subject, but you can look for yourself at PubMed here. The physiology of Benign Paroxysmal Positional Vertigo (BPPV) is dislodged calcium carbonate crystals in the inner ear. This is quite different from the physiology at work in Meniere’s Disease (or, at least the prevailing, but not universally held, theory of the physiology at work in Meniere’s Disease), which is excess endolymphatic fluid due to either overproduction or underresorption. See the MenieresInfo.com Cause Page. We don’t see a connection. Surely, though, it is possible that one can develop both Meniere’s Disease and any other medical disorder.
But that’s not our reader’s question. Our reader asks how likely that one would be diagnosed with both BPPV and Meniere’s Disease, and our reader asks that without regard to whether one actually has both BPPV and Meniere’s Disease. BPPV is easier to diagnose than Meniere’s Disease. We know that Meniere’s Disease is difficult to diagnose, because there is no definitive test for Meniere’s Disease, and in some cases, it is just the default diagnosis when no other cause for one’s symptoms can be identified. BPPV can certainly “mimic” Meniere’s Disease. See the MenieresInfo.com Diagnosis Page. We wouldn’t fault a doctor for a “what the heck” try at relieving one’s symptoms through the positional maneuvers that are so successful at treating BPPV. If that is done, and the patient improves somewhat, it would be tempting to add BPPV to the diagnosis.
But what our reader is actually doing is evincing skepticism over a diagnosis of both BPPV and Meniere’s Disease. We always recommend multiple medical opinions, both for diagnosis and for treatment options. See the MenieresInfo.com Doctors Page.