👂 Vestibular Neuritis vs BPPV vs Meniere's Disease Simulator

Attack Duration as the Primary Differentiator

Vertigo duration alone narrows the diagnosis dramatically.

• <60s: BPPV episode (seconds per spell)
• 1–5 d: Neuritis episode (continuous course)
• 20min–12h: Meniere's episode (discrete hours)
• Moderate: Overlap risk (history is essential)

Why duration matters most

Placeholder: duration buckets map cleanly onto three distinct vestibular disorders.

Positional Trigger — the BPPV Hallmark

Head-position change provoking brief vertigo defines BPPV.

• Positional: Trigger (rolling, looking up)
• Dix-Hallpike: Test (reproduces nystagmus)
• <60s: Duration (per episode)
• Absent: Hearing loss (never a BPPV feature)

Positional mechanism

Placeholder: otoconia debris in semicircular canals cause brief positional spins.

Continuous Days-Long Vertigo — the Neuritis Pattern

Sudden, unrelenting vertigo over days suggests vestibular neuritis.

• Sudden: Onset (often viral prodrome)
• Days: Duration (gradually improving)
• Absent: Hearing loss (distinguishes from labyrinthitis)
• Unidirectional: Nystagmus (horizontal-torsional)

Continuous course

Placeholder: unilateral vestibular nerve inflammation drives constant imbalance.

Episodic Hours With Hearing Symptoms — Meniere's Disease

Vertigo lasting hours with hearing loss and tinnitus signals Meniere's.

• 20min–12h: Duration (per attack)
• Fluctuating: Hearing loss (low-frequency)
• Present: Tinnitus (often unilateral)
• Common: Aural fullness (pre-attack sign)

Endolymphatic hydrops

Placeholder: fluid pressure changes in the inner ear drive episodic attacks.

Associated-Symptom Differentiation Algorithm

Combining duration, trigger, and hearing symptoms yields a diagnosis.

• Duration: Step 1 (seconds/hours/days)
• Trigger: Step 2 (positional or spontaneous)
• Hearing: Step 3 (present or absent)
• 3-way call: Output (BPPV / neuritis / Meniere's)

Decision summary

Placeholder: algorithm combines three history features into one classification.

Placeholder: always confirm with bedside exam findings, not history alone.