[Differential diagnosis of benign paroxysmal positional vertigo in Menière's disease]

135 patients with BPPV and 56 patients with Meniere's disease were evaluated critically. The reliability of the diagnostic criteria (history and physical examination, audiograms and vestibular function tests) were compared. History, physical examination and patients' complaints were inconclusive. Moderate or severe medio- or pancochlear inner ear damage was more reliable, but not pathognomonic of Meniere's disease. Patients with BPPV had normal hearing or a high-frequency loss. Electronystagmographically recorded vestibular function tests were unreliable in establishing the diagnosis. The most valid test to distinguish BPPV and Meniere's disease was Hallpike's positional test, using Frenzel's spectacles for better observation of the provoked nystagmus.