Labyrinthitis and Meniere's disease

I have heard the name labyrinthitis in many articles about balance disorders, so I decided to do a little research. It seems that it is a balance disorder that occurs from a virus with hearing loss and tinnitus. The brain receives signals from both ears to determine your balance, but when you have labyrinthitis, the signal in one ear drops off and that gives the brain an incorrect reading.

Well there seems to be similarities between meniere’s disease and labyrinthitis, such as hearing loss and tinnitus and the fact that MM is supposedly caused by a virus. But there are differences also.

Something else that I read was that labyrinthitis doesn’t come and go; it stays for a while, Unlike Meniere’s disease that comes and goes as it pleases. And labyrinthitis is usually a one time deal where you get the vertigo and the throwing up and then it leaves you, like having a bad case of the flu. The hearing loss is usually temporary.

The medication that is given is pretty much the same as those given to a meniere’s patient: valium, Antivert and antihistamines.

If the case of labyrinthitis lasts a long time it might be a sign of vestibular neuritis. With vestibular neuritis the inflammation is coming from the vestibular nerve as opposed to the inner ear where labyrinthitis occurs. Sometimes it is impossible to tell the difference between the two.

How is Meniere’s disease diagnosed?

How and when did I know I had Meniere’s Disease?

When I first started to get dizzy a few weeks after my car accident, I didn’t know what was wrong with me. I had heard about vertigo, but like most folks I wasn’t sure exactly what it was. I remembered the movie and it seemed to be about a fear of heights, nothing about dizziness. I began to wonder if it was a heart attack. So I was anxious to get to the doctor.

I went to my regular doctor and he immediately sent me to an ENT because if it had to do with balance that would be the first place to go. When I got to the ENT’s office I was put through a series of tests, first hearing, and then balance. After examining the results the doctor indicated that I had lost a good deal of hearing in my left hear. He also stated that it didn’t look like I had vertigo. The next step was to have an MRI, something that I had had in the past and dreaded. He told me that it was necessary so he could rule out a tumor.

Luckily, the MRI machine was partially open, so I didn’t feel like I was crammed in a hole. The test came back, no tumor.
At that point the ENT told me that I might have Meniere’s Disease, he explained that this was the term that was generally used when vertigo was ruled out and there wasn’t any brain tumor.

So, to recap my diagnosis was reached by hearing tests, balance tests and a MRI. I know other doctors use different tests, such as the caloric test, to determine if it is Meniere’s Disease. But most all of them use MRI.

Meniere's Disease and Nystagmus

Last Friday I wrote a post about my current condition of Meniere’s disease, later that same evening I again had another attack this time it was involving spinning which lasted quite awhile. I had taken an phenagan which helped me to sleep but I woke up on Saturday around noon. I was still very tired.

Now that I have had time to think about the attack I believe that I had nystagmus that evening. I was watching TV and my eyes jerked to the side rapidly. The definition of nystagmus is involuntary eye movement. It was definitely involuntary!

It seems that nystagmus is common with vertigo and meniere’s patients. The way to test if you have nystagmus is by using the caloric water test. That is the test that I chickened out on with the VRT therapist.

Maybe I should reconsider.

Anyway if you want to read more on nystagmus click on the following link
http://www.tchain.com/otoneurology/practice/nystagmus.html
Dr Hain is well known as an expert on all things dealing with dizziness and balance.

An update on my Meniere's Disease

Since the first of the year I haven’t had any attacks. There were a few close calls but nothing like the attacks that I had last fall after the gentamicin injections. I truly believed that the Meniere’s disease was basically over for me. I took the diazide, valium and the supplement every day and that would ward off any attacks.

But that came to an end today.

I guess I should have seen it coming. I was on vacation this week and I took a plane trip to see my mother in Pittsburgh. I haven’t been on a plane in two years and I was worried about how it would affect me. The takeoff was very rough, I put my hands over my ears but that didn’t stop the pounding of the elevated air pressure in my inner ears. My ears seemed to get adjusted to the pressure as the flight continued. When the plane landed everything seemed to be normal.

My mother lives in a small town in Pennsylvania on the border of West Virginia. As is most of Pennsylvania the area is particularly hilly, so most of the four day stay I was driving up and down hills and mountains. One day we drove into West Virginia over winding roads that cut over and through the Appalachian Mountains, this made me sick. I took an Antivert when the ride was over and that seemed to help.

The plane flight home was worse than the flight to Pittsburgh. There was quite a bit of turbulence in the air enough to make anyone sick and the landing wasn’t that great either. Well, I thought now that the round trip flight was over everything would be back to normal.

Of course I was wrong.

I had relaxed most of the day and even took my son swimming for a few hours in the afternoon. Right after dinner I lay down in the bedroom and watched the news. As I lay there, my head started to become light and the TV picture appeared to be shifting slightly to the right. That’s when I though I better turn the TV off. Before I could reach for the remote my head jerked to the right and the room turned upside down! I let out a yell and my wife immediately came into the bedroom. She got me an Antivert and I lay perfectly still. But the strange part about it all was that the room didn’t continue to spin and I wasn’t nauseated. In the past, I would have spinning for an hour and throwing up everything I had eaten in a week!

It was all very strange. Was it the plane flight that brought it on? Or was it something else? I don’t know but I hope to God that it was only a blip in my recovery.

Famous sufferers of Meniere’s Disease

Alan Shepard, the first astronaut in space, had meniere’s disease. He was treated with surgery and was able to continue as an astronaut.

Vincent Van Gogh was reported to have meniere’s disease. I have also read that he didn’t have it, but who knows since he died in the 18th century.

The great author Jonathan Swift.

Emily Dickinson was also reported to have meniere’s disease.

Ryan Adams and Kristen Chenoweth are 2 living performers who have meniere’s disease.

Meniere’s disease and nausea

What is the worse thing about having a Meniere’s attack? Is it the uncontrollable spinning or is it the fact that you can’t move. Or maybe it is the sweat pouring off of you as helplessly lie on the floor. All of those are pretty terrible but the one I can’t stand is the vomiting. I don’t vomit each time I get an attack but when I do its bad. And when you have thrown up so many times that your stomach is empty it is really bad. My throat and my ribs would be sore for days after a bad attack.

The best way for me to prevent throwing up is to stay perfectly still. I stare ahead with my eyes open concentrating on a spot in front of me. This can be difficult because of the spinning sensation which makes it difficult to focus. If I move or turn my head just the littlest bit my stomach will turn and then I will start throwing up.

Another thing that works for me is phenagan. If I am at home and I feel an attack coming on I take a phenagan which helps with the nausea and it also a sedative. So I really have to be home to take it. Driving shouldn’t be attempted if you take phenagan.

Another reason that I take phenagan is that the many times that I went to the emergency room I was always given it in the ambulance, Of course it given through an IV.

Meniere's Disease and cochlear implants

In a previous post I mentioned that almost 50 percent of Meniere’s disease patients develop this illness in both ears (bilateral). That’s why it is so important to take this in consideration when going forward with any procedure or surgery. You don’t want to lose hearing and balance in both ears.

A cochlear implant is a small device that helps people with hearing problems have a sense of sound. Although it doesn’t replace or repair your hearing it makes the sounds and words clearer. Meniere’s patients who have the bilateral type of the disease are a candidate for this type of implant.

The surgery takes about 2 hours and requires an overnight stay at the hospital. The implant is placed inside the skull with the wiring close to the auditory nerve. The patient wears a device that looks like a hearing aid to pick up the sounds. It takes about a week to recover.

The hearing that comes from the implant isn’t as clear as normal hearing but it can be clear enough for words to be understood.

There are risks, such as facial nerve damage and the risk of the device not working.

What to do about tinnitus?

I have been fortunate that the tinnitus that I have had isn’t constant. It seems to be a warning bell for me that I am about to have an attack. An attack isn’t always forth coming but I take heed and prepare myself for the worse.

But for many other Meniere’s disease sufferers tinnitus is an accomplice of Meniere’s disease. They have had both ailments continuously. My heart goes out to them because it’s bad enough to worry about having a spinning, spiraling out of control attack where you throw up and almost pass out, then add an annoying sound blaring in your ears.

But there are things that you can do to ease the pain of tinnitus.

The simplest might be to remove wax from your ear. Be careful when doing this and remember not to stick a q-tip inside your ear. If the wax is extremely bad your doctor can remove it.

White noise machines are also recommended to help lessen the annoying sound of tinnitus. I use one at night and they really work.

Medication can also be a factor in creating tinnitus. Your doctor will be able to tell you all the medication that may cause tinnitus.

This is something that I haven’t heard about before called masking devices. They are like a hearing aid but they produce white noise.

You probably already do this; avoid extremely loud noise or music. This is also good at preventing headaches.

You might not like this one, avoid alcohol. It’s just advice.

Of course the best advice is to do all the research that you can and work with your doctor on finding the best treatment for you.

What is The Epley maneuver?

The Epley maneuver is a procedure that relieves patients of their vertigo (Benign paroxysmal positional vertigo) it was developed by Dr. John Epley. It is an in office procedure where the patient’s head is moved into 4 different positions and held there for a period of time. This causes the particles floating the inner ear to be dislodged and moved to an area where they wouldn’t send incorrect balance information the brain. The whole procedures take around 15 minutes.



For the next two days after the procedure the patient has to keep their head fairly erect and vertical so the particles can’t float back to their prior position. That means sleeping at a 45 degree angle (lots of pillows). I know that doesn’t sound too good but the success rate is around 80 percent. Unfortunately this doesn’t help Meniere’s disease patients.

There is also a home Epley maneuver. If you want to see a demonstration of it here is the link to Dr. Hain from the Dizzy and Balance Clinic.


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