Meniere’s Disease

June 11, 2014 by
Filed under: Case of the month, Cases, Spinewave Bulletin, Symptoms 

menieres-disease-upper-cervical-300x151I have not had an episode of vertigo or nausea since January – Pip Z.

Meniere’s disease (or syndrome) is characterised by vertigo or dizziness, and some combination of four associated symptoms: nausea, inner ear pressure, low-frequency hearing loss and tinnitus.

The cause of Meniere’s disease is unknown and the pathology is poorly understood. The attacks of vertigo appear suddenly, last from a few to 24 hours, and subside gradually. The attacks are associated with nausea and vomiting. The person may have a recurrent feeling of fullness in the affected ear and hearing in that ear tends to fluctuate, but worsens over the years. Tinnitus (ringing ears) may be constant or intermittent. Other symptoms often associated with Meniere’s syndrome are nystagmus, brain fog, headaches, depression, neck stiffness, sinus pain and fatigue. Skip to story.


Mechanical cause

Meniere’s disease can often take many years to manifest. All patients with a history of tinnitus, vertigo or dizziness should be questioned about a history of trauma, especially whiplash from a car accident, contact sports injury, or serious fall1. People often forget these accidents, thinking that they were not hurt because they did not break any bones and were not bleeding.

Dizziness related to perturbations in information received from joint receptors in the neck that feed into the vestibular system are not usually taken into consideration. Decreases in sensory information to the brainstem (medullary somatosensory nucleus) from a problematic upper cervical spine can lead to overactivation of the dorsal cochlear nucleus. This may result in an increase in perception of tinnitus.

 tinnitus-head-and-neck

Non-mechanical cause

Any model of tinnitus or dizziness that looks at the cochlear (ear) in isolation is now considered inadequate2. It is not always necessary that tinnitus or dizziness be derived only from the ear. A neurological model now considers tinnitus and vertigo to be part of a much wider system issue, involving auditory perception in the brain, limbic emotional centres, and the autonomic nervous system (fight/flight stress). This is why prolonged periods of fear, anxiety, tension and stress can manifest with Menieres-like symptoms such as vertigo or tinnitus.

brain-tinnitus-vertigo-menieres

 

On the morning of January 23, 2013, I ended up in an ambulance on my way to hospital. I was suffering from extreme vertigo, vomiting and I was unable to walk.

I was discharged from ED early that evening with the possible diagnosis of vestibular neuritis and given medications to help curb the vomiting.

For many weeks after this event I had the same episode almost every month for three months. I went to see an ear, nose and throat (ENT) specialist who sent me for an MRI, as well as to the balance disorder clinic. All the “nasties” were ruled out and vestibular neuritis was the diagnosis.

Over December/January 2014 the vertiginous episodes reoccurred. I visited the ENT specialist again and it was suggested I had Meniere’s disease. I was again given medication for the vertigo and nausea.

Over the following weeks I spent a number of hours researching anything I could do to help alleviate the symptoms of Meniere’s disease. This is how I discovered Neil and Pip at Spinewave.

I have been seeing the team at Spinewave since the middle of March and I am feeling great. I have not had an episode of vertigo or nausea since January.

The team at Spinewave have been helpful and supportive throughout my treatments. The knowledge I have gained and the trust I now have in chiropractic has been fundamental in my great results. I am not sure if Neil and Pip realise they now have me forever!

Pip Z.

© Spinewave 2014

References:

  1. Burcon, M. Upper cervical protocol to reduce vertebral subluxation in ten subjects with Meniere’s: a case series. J of Vertebral Subluxation Res. 2008. 1-8.
  2. Baguley, D. M. Mechanisms of tinnitus. British Medical Bulletin. 2002. 63: 195–212.
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