NEWS: Researchers may have discovered a plan to disable Meniere’s Syndrome

NEWS: Researchers may have discovered a plan to disable Meniere’s Syndrome

NEWS: Researchers may have discovered a plan to disable Meniere’s Syndrome

Diagram of the cochlear-vestibular systemOriginal title:  Researchers may have discovered a plan to disable Meniere’s disease

Researchers at the University of Colorado School of Medicine in Denver may have figured out what causes Meniere’s disease and how to attack it. According to Carol Foster MD, from the department of otolaryngology and Robert Breeze MD, a neurosurgeon, there is a strong association between Meniere’s disease and conditions involving temporary low blood flow in the brain such as migraine headaches.

Meniere’s affects approximately 3 to 5 million people in the United States. It is a disabling disorder resulting in repeated violent attacks of dizziness, ringing in the ear and hearing loss that can last for hours and can ultimately cause permanent deafness in the affected ear. Up until now, the cause of the attacks has been unknown, with no theory fully explaining the many symptoms and signs of the disorder.

“If our hypothesis is confirmed, treatment of vascular risk factors may allow control of symptoms and result in a decreased need for surgeries that destroy the balance function in order to control the spell” said Foster. “If attacks are controlled, the previously inevitable progression to severe hearing loss may be preventable in some cases.”

Foster explains that these attacks can be caused by a combination of two factors:

  1. A malformation of the inner ear, endolymphatic hydrops (the inner ear dilated with fluid)
  2. Risk factors for vascular disease in the brain, such as migraine, sleep apnea, smoking and atherosclerosis.

The researchers propose that a fluid buildup in part of the inner ear, which is strongly associated with Meniere attacks, indicates the presence of a pressure-regulation problem that acts to cause mild, intermittent decreases of blood flow within the ear. When this is combined with vascular diseases that also lower blood flow to the brain and ear, sudden loss of blood flow similar to transient ischemic attacks (or mini strokes) in the brain can be generated in the inner ear sensory tissues. In young people who have hydrops without vascular disorders, no attacks occur because blood flow continues in spite of these fluctuations. However, in people with vascular diseases, these fluctuations are sufficient to rob the ear of blood flow and the nutrients the blood provides. When the tissues that sense hearing and motion are starved of blood, they stop sending signals to the brain, which sets off the vertigo, tinnitus and hearing loss in the disorder.

Restoration of blood flow does not resolve the problem. Scientists believe it triggers a damaging after-effect called the ischemia-reperfusion pathway in the excitable tissues of the ear that silences the ear for several hours, resulting in the prolonged severe vertigo and hearing loss that is characteristic of the disorder. Although most of the tissues recover, each spell results in small areas of damage that over time results in permanent loss of both hearing and balance function in the ear.

Since the first linkage of endolymphatic hydrops and Meniere’s disease in 1938, a variety of mechanisms have been proposed to explain the attacks and the progressive deafness, but no answer has explained all aspects of the disorder, and no treatment based on these theories has proven capable of controlling the progression of the disease. This new theory, if proven, would provide many new avenues of treatment for this previously poorly-controlled disorder.

Expert analysis:

When we posted this article on Facebook, it elicited these comments from two eminent otologists. From one at the House Ear Clinic:

Interesting. One of the problems with treating Meniere’s Syndrome is that we are probably dealing with several diseases that manifest themselves with the same clinical syndrome. Vascular causes, allergy, autoimmune causes, degradation from infection and trauma, delayed hydrops from contralateral insults. I think this is part of the reason why it’s difficult to get a handle on it.

Another otologist on the faculty of a prestigious Mideast medical school commented:

Back to square one. Peripheral vascular etiology is a remote possibility to explain the clinical variants of Meniere. Central pathology, i.e. MAD (migraine associated dizziness) as an explanation of Meniere brings [us] back to the era before the discovery of endolymphatic hydrops as a histopathological finding. I rather stick to the mechano-biochemical theory.

References:

The Meniere attack: An ischemia/reperfusion disorder of inner ear sensory tissues, Foster CA, Breeze RE: Medical Hypotheses, December 2013. [Mirror PDF copy available here.]

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About the author

Dan Schwartz

Electrical Engineer, via Georgia Tech

5 Comments

  1. Mike
    January 3, 2014 at 11:54 am

    We have known for years that blood flow is at least part of the problem but the actual causes are varied and I agree to an extent with the 1st otologist. I do believe however from our experience in supporting Meniere’s sufferers for over 10 years at Menieres-Help.Com and from over 5 years of research and study into underlying causes that everyone can find their triggers and underlying cause, then deal with it. If anyone needs any help with this email me direct at meniereshelp@gmail.com


  2. Susan Kee
    January 3, 2014 at 2:06 pm

    what an incredibly mis-leading headline! Copy editor!! Copy editor!!


    • Dan Schwartz
      January 3, 2014 at 4:45 pm

      And how is it misleading?


      • Susan Klee
        January 5, 2014 at 1:22 am

        The headline claims there may be a solution to the problem. The text explains that this is not the case. I call that misleading.


    • Agung
      May 20, 2014 at 2:46 am

      Dan, thanks so much for taking the time to share your story. Reading your trial of getting home brought so much back for me. The last bout of vertigo I had was mid-May while I was finishing up the cookbook. I walked to the fridge to get out something, opened the door, and BAM!! out of nowhere, the entire fridge started tilting on its side. It wasn’t the fridge, of course, it was me, but the terror that vertigo induces cannot be described. I immediately sat down, panic stricken. I don’t take medication any longer, it just seems to whack me out. I’ve found the best way to cope is to sit as absolutely still as possible, NOT move my head, and try as I might to focus on a single point. I shut my eyes if need be. I remind myself over and over, This will pass. This will pass. and without fail I beg God to help me. So far, so good. I must tell you, I’ve not had a single attack of vertigo since I went vegan 4 months ago. In addition, I’ve contended less less with dizziness and the other ear symptoms. I used to be plagued incessantly with my ear popping or feeling full, with fading hearing and increased tinnitus, it was so frequent I simply ignored it much of the time. Now it seems very different. The symptoms when they arise seem more like anomalies, not constant companions. I can only say that I TRULY believe in the power of this diet. Not just low sodium, but completely plant based, devoid of any animal products. After just 4 months, I know it can heal.


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