Benign recurrent vertigo--true or artificial diagnosis?

The etiology of many diseases involving vertigo is still unknown although the same etiologic factors have been suggested for several diseases. In most cases the diseases are diagnosed on the basis of exclusion-other possible causes being ruled out before the diagnosis can be confirmed. Benign recurrent vertigo (BRV) has been defined as spells of vertigo characteristic of Menieres disease without auditory or clinical neurologic symptoms and signs. The etiology of this condition is also unknown. BRV has been linked to migraine and viral diseases. In a prospective study we collected the clinical history and the signs and results of neurotologic and audiologic tests from 33 patients with a BRV diagnosis. The clinical characteristics truly mimicked the vertigo seen in Menieres disease. The concept of vestibular Menieres disease is not widely accepted, and without auditory signs BRV is the only diagnosis that can be given to these patients. In other studies up to 25% of the patients initially diagnosed with BRV subsequently developed another peripheral vestibular disorder. Until the etiology of diseases involving vertigo is more clearly understood, artificial diagnoses like BRV, must be accepted.