Perhaps 50% of all the cases considered as Ménière's disease prove on further careful examination to be of cardiovascular origin. When a patient who complains of dizziness is examined, the following preliminary classification can usually be arrived at by simple history.
(1) If dizziness occurs with a feeling of a blurring or clouding of vision, "black before the eyes," one is usually dealing with a circulatory type of dizziness. If the dizziness often increases on bending or stooping, the patient may have a very high or a very low blood pressure or some general illness.
(2) Dizziness which ceases upon closing the eyes suggests an ocular disturbance, and there is no rotation of objects.
(3) Dizziness which produces the sensation of giddiness or unsteadiness, without nausea or ataxia, is due to an arteriosclerosis of the cerebral vessels unless otherwise proved and is most frequent in patients past 60 years of
GOODYEAR HM. Ménière's Disease: Treatment and Practical Differentiation and Diagnosis of Various Types of Dizziness. AMA Arch Otolaryngol. 1956;63(4):343–346. doi:10.1001/archotol.1956.03830100001001
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