Does anyone have any experience with Ménière’s Disease, Labyrinthitis and Vestibular Neuritis or similar disorders of the inner ear? DW experienced increased tinnitus and pressure in one of her ears after an airplane flight last month. She had similar symptoms after a flight a couple of years ago (but no problem on several flights in the interim). A few weeks later and she’s had two attacks of vertigo and nausea. A CAT scan and MRI are unremarkable. She just had a videonystagmography test yesterday and an electrocochleography test next week. I’d appreciate feedback from anyone who has had these or similar problems.
Has she thought of TMJ? I had a similar experience after flying last year. I went to an audiologist to check it out. He diagnosed TMJ and referred me on. I never followed up with the specialist. I became more aware of " gribbing" in my jaw. Gradually sorted itself.
I have it! It is crazy and unpredictable, but manageable with the right dr. First of all, there is a genetic link to Menieres. I didn’t know it, but when I was diagnosed, I found out my two paternal aunts both have it. I was hospitalized with vestibular neuritis for 10 days about 8 years ago. I had vertigo and tinnitus with a full feeling in my ear. The only way I got rid of the ear symptoms ws to do the tilt test and maneuvering which was bad, but worth it. Since then, I am on triamterene daily (basically a water pill bc it reduces the pressure in your inner ear). Avoid salt and heavy alcohol-trigger factors. Finally, when I get a bout of vertigo (I have gone MONTHS without a hint of it and find it flairs up during stressful times), i take Meclizine. It works but makes you very very tired. I have learned to take half a dose during the day and a full dose at night. The most important thing is getting to a doctor that knows how to treat this disease, and to remember that it goes as fast as it comes, with proper management. Feel free to contact me with any questions. I am in New York if that helps.
I’ve seen an ENT for treatment of vertigo. A few points:
- Avoid alcohol if there are any symptoms present. Alcohol disrupts the vestibular system and leaves balance up to the eyes for as long as 72 hours. Since a symptom of the condition is poor visual tracking, this can mean "oh oh, I'm going to fall down" syndrome. A simple test of visual tracking is to draw a finger in front of the eyes. If you have it, you experience a sort of difficulty holding clear focus and the person observing can see the eyes lag and catch up. A basic exercise is to try to track things. Another is to shake the head up and down, side to side and try to focus on something, meaning you induce vertigo enough to exercise against it. Do both seated.
- Often associated with inflammation of the facial nerve(s). Take a finger and press below the cheek bone and if it hurts, that's inflamed. This seems to happen because of chicken pox (zoster) cycling back in the system and the immune system response: it (stupidly) attacks the same nerve pathways that lead eventually to the inner ear. A treatment, effective or not, is anti-viral medication for about 3 weeks to (maybe) suppress the viral load. The parantheticals are because this isn't necessarily effective. Or you outwait it.
- Some people are crippled by this; it won't go away. But most find it fades out, comes back every now and then, etc. I've never had it again as bad as my first episodes. I was carted off to the ER once and completely lost vision a few times - seeing only 3 weird circles - and had to grab on to something for a second. But it has had some weird side effects, as in I walked out on a bridge to look out and almost had to crawl back. So be careful about things like that.
- Standard treatment is antihistamine - meclizine mostly. There's not much else to do.
I am in the middle of treatment with a physical therapist for vertigo. My intermittent symptoms that began more than 15 years ago are sometimes so severe that I can’t walk without holding on to a wall. I have been checked by my PCP, an ENT, and run through hours of tests at Pitt. The tests were all negative. The problem seems to be in my right ear which at times feels like it is full of water. My latest bout started when I was a passenger in a car that was rear-ended and I had moderate whiplash. Since I was on the way to my doctor’s office to have my severe cough checked out (I had bronchitis), the dr. checked me for injury. Other than a sore neck, everything seemed o.k. Twenty-four hours later, I had severe vertigo, so I called my dr. and got a referral for physical therapy.
My PT did the assessment for BPPV (benign paroxysmal positional vertigo) which I do have, and explained the cause and treatment. Over the course of treatment, we have discussed the difficulty in getting an accurate diagnosis of vestibular problems. BPPV is fairly common and shouldn’t have taken 15 years and numerous doctor visits and tests to diagnose.
I am not suggesting that your wife has BPPV, just sharing my difficulty in getting a diagnosis for a similar condition that comes and goes.
Thank you to all who replied! Yes, my wife had TMJ 25 years ago, but that seems not to be an issue now (at least I think not). She has taken meclizine for the vertigo with the side effects mentioned above. Hopefully the symptoms will be less frequent. She says she’s feeling pretty good today.
If you live near a large teaching hospital it may be worth a visit to a specialist familiar with the various causes of vertigo. They will review the results of tests done, come up with a hypothesis for an underlying cause and suggest a treatment plan based on the most recent data available. Not sure where you are located, but Dr. Erik Viirre at UC San Diego specializes in neurotology. Hormonal changes, allergies and viruses are all common triggers of vertigo. A simple 5 day tapered dose of prednisone helped to reverse a bout of vertigo more than 10 years ago for me. My HMO ENT doctor was skeptical, claiming “everyone feels better” on prednisone. But the treatment marked a significant improvement and indicated that the underlying issue was immune mediated inflammation. I still have trouble during allergy season but the over-the-counter antihistamines are helpful.
I’ve had episodes of BPPV. I’ve done the Epley maneuver, which worked for me for most of the episodes. Knock on wood, I haven’t had an episode for a while.
Husband had vertigo and did the “exercises” worked like a charm - went away in a few days/week?
My S1 experienced this as a senior in college and after work-ups by a team of neurotologists he was diagnosed with a granuloma on his inner ear. His symptoms did abate and now he takes meclizine when it flares.
I have had vertigo for over 20 years & others in my family have it, too, though each person has their own symptom manifestation. One person cannot look at water without being queasy, another person cannot drive long distances, another does not fly well, etc.
What I learned is that doctors (at least in the 90s) are more about quantity of life than quality of life, tests were performed, meclizine given (um, I have kids & a job, giving me a medication that puts me to sleep really is not a help), etc. For me, I learned my triggers, it took several years before I did some particular triggers every week on the same day and realized I was throwing up every Tuesday (slow learner?) and stopped the triggers. It is an art to discern when you are pre-vertigo, at risk, vulnerable, and then to do all you can to avoid proceeding. In the past 20 years I have had many days/weeks of being pre-vertigo and being careful, one after a bad chiropractic adjustment which pinched a nerve and one after being inclined head down for 6 hours.
One thing that helped a great deal about 10-15 years ago I joined a Yahoo group on behalf of a family member with a related issue & reading all those posts, all those stories, over several years did clue me in to more unusual triggers. I make a concerted effort now to sense and avoid progression.
My dad has Menieres and when he first had the attacks he was really in bad shape. He cut back on his salt intake and he has been fine since.
My mother and I suffer from Meniere’s disease. With us, the attacks are pretty rare, luckily: I’ve had 3 in the past 10 years. But when they come, they’re doozies: 12, 14 hours in bed with vertigo so powerful I can’t open my eyes or even shift my position. The attacks come out of the blue - once I woke up with it. Sadly, doctors told me there’s not much I can do about it. My hearing is still OK (although I can’t tolerate some of the more involved hearing tests) but mom is a bit hard of hearing.
I have to agree it is an art to understand your triggers/symptoms for vertigo. One of mine, for example, is when my vision in my right eye becomes even more far-sighted (than my usual 20-10) and that tells me to be careful.
A few other comments:
- Working on balance really, really helps. I do balance exercises every day. They challenge the vestibular system and help me respond quickly and without panic.
- Strength training helps. I've found being strong lets me compensate much better. By strength, I mean all sorts of things from weight training to yoga to pilates.
Since it happens after air flight, add perilymphatic fistula to the list of possible causes. Given the tests she is having it sounds like she is in good hands.
DW asks me to add another symptom to your differential diagnosis - she has had a measurable hearing loss in the ear that has the pressure and tinnitus after the air travel. In the episode 2 years ago some of that hearing loss was recovered after prednisone, but this time around she still has the hearing loss in that ear.
Thanks again for all the comments. Will keep you all posted if she learns more.
Of Meniere’s, perilymph fistula, labyrinthitis and vestibular neuritis, the last one usually does not involve hearing loss but the first three can. Electrocochleography can help diagnose Meniere’s.
Thanks, I’ll keep folks updated after my wife has her electrocochleography