You will research the two areas of content assigned to you and compare and contrast them in a discussion post. NOTE: A comparison and contrast assignment is not about listing the info regarding each disease separately but rather looking at each disease side by side and discussing the similarities and differences given the categories below. Consider how each patient would actually present to the office. Paint a picture of how that patient would look, act, what story they would tell. Consider how their history would affect their diagnosis, etc. Evaluation of mastery is focused on the student\’s ability to demonstrate specific understanding of how the diagnoses differ and relate to one another. Address the following topics below in your own words:
Presentation
Pathophysiology
Assessment
Diagnosis
Treatment
The two diseases to be compared are:
Benign Positional Vertigo and Meniere\’s Disease
Advanced Clinical Diagnosis
Student’s Name
Institutional Affiliations
Advanced Clinical Diagnosis
Some medical conditions might have almost similar symptoms which may cause confusion during the subjective assessment. In such a case, the clinician should be adequately informed of specific details in the client’s presentation to be able to differentiate between such conditions. Information regarding disease pathophysiology, objective assessment, and diagnosis can help the clinician to differentiate between almost similar medical conditions. The healthcare professional should begin treatment only after making an accurate diagnosis (Mayo Clinic, 2021). The purpose of this assessment is to compare and contrast two medical conditions namely; Benign Positional Vertigo and Meniere’s Disease. The areas of analysis include presentation, pathophysiology, assessment, diagnosis, and treatment.
Presentation
There are some differences and similarities in the presentations of Benign Positional Vertigo and Meniere’s Disease. The similarity is that patients with both conditions present with dizziness, a swaying sensation, spinning, tilting, and unbalanced feelings which are severe with movement and subside when a person is at rest (Liu et al., 2020; Kim et al., 2021). However, patients with Meniere’s Disease usually present with additional symptoms that are usually absent in patients with Benign Positional Vertigo. The additional symptoms include; sensorineural hearing loss in one ear of low to medium frequency and fluctuating aural symptoms including tinnitus, fullness, and hearing which cannot be attributed to any other cause with vestibular diagnosis (Kim et al., 2021).
Pathophysiology
Both Benign Positional Vertigo and Meniere’s Disease are diseases of the ear. However, there is a difference in the pathophysiology of the two conditions. The pathophysiology of Benign positional vertigo entails the dislodge and settlement of otoconia within the semicircular canal endolymph. Movement of the head causes a displacement of the otoconia which shifts towards the fluids thereby causing disease symptoms (Kim et al., 2021). On the other hand, the pathophysiology of Meniere’s Disease entails the proliferation of the fibrous tissue in the saccular, vestibular aqueduct hypoplasia, and degeneration of the spiral ganglion at the apex of the cochlea (Liu et al., 2020).
Assessment
Assessment of both Benign Positional Vertigo and Meniere’s Disease can help the healthcare professional to make an accurate diagnosis. Assessment of the two conditions is that the healthcare professional must collect both subjective and objective assessment information during patient evaluation. The other similarity is that the objective assessment or physical examination is concentrated in the patient’s ears (Kim et al., 2021; Liu et al., 2020). Imaging procedures such as magnetic resonance imaging (MRI) are done in both Benign Positional Vertigo and Meniere’s Disease. However, there is a difference in some of the procedures performed when conducting a physical exam of patients with the two conditions. The procedures are the same ones conducted during diagnosis and are discussed under the ‘Diagnosis’ section.
Diagnosis
It is important to make an accurate diagnosis before starting treatment of patients with Benign Positional Vertigo and Meniere’s Disease. In both conditions, diagnosis is made using a combination of both subjective and objective assessment results. The other similarity is that MRI, computed tomography (CT) scan, and videonystagmography (VNG) are usually conducted to rule out the possibility of other conditions (Liu et al., 2020; Kim et al., 2021). However, Electronystagmography (ENG) is done in Benign Positional Vertigo but not in Meniere’s Disease. Other diagnostic tests that are done in Meniere’s disease but not in Benign Positional Vertigo include Rotary-chair testing, Vestibular-evoked myogenic potentials (VEMP) testing, Posturography, Video head impulse test (vHIT), and Electrocochleography (ECoG) (Kim et al., 2021; Liu et al., 2020).
Treatment
Since patients with Benign Positional Vertigo and Meniere’s Disease present with vertigo, patients with both conditions are usually treated with medications that relieve vertigo. The evidence-based drugs for vertigo are motion sickness drugs such as meclizine or diazepam (Valium) and antinausea medications such as promethazine. Surgical procedures and positive pressure therapy can also be performed on patients with Benign Positional Vertigo and Meniere’s Disease (Mayo Clinic, 2021; Kim et al., 2021).
References
Kim, H. J., Park, J. & Kim, J. S. (2021). Update on benign paroxysmal positional vertigo. Journal of Neurology, 268, 1995–2000. https://doi.org/10.1007/s00415-020-10314-7
Liu, Y., Yang, J. & Duan, M. (2020) Current status on researches of Meniere’s disease: a review. Acta Oto-Laryngologica, 140(10), 808-812, doi: 10.1080/00016489.2020.1776385.
Mayo Clinic. (2021). Meniere’s disease. https://www.mayoclinic.org/diseases-conditions/menieres-disease/diagnosis-treatment/drc-20374916