Very descriptive and to the point. Probably won't tell you anything you don't know but for those interested in studying this further, there are good footnotes and references http://www.bmj.com/cgi/content/full/316/7128/368 George
Re: excellent article Hi George, It is a very good article even for an oldie like myself. I think that link should go into the data base as it is written in simple terms but also comprehensive. I was glad to see that Serc was listed as being an effective treatment of Meniere’s disease for some people. Too many of the older studies were listing it as being an unproven therapy. Perhaps, this will encourage more people to try this medication to see if it works in their case. Joe
Hi George, Just got around to reading the subject article this morning. There are a few points in the article that invite comment. First, it lists among other possible causes an anatomical cause. That cause would be "associated with several abnormalities of the temporal bone, including reduced pneumatisation (air cavities) of the mastoid and hypoplasia (underdevelopment)of the vestibular aqueduct." Now, that could be a cause I suppose; still I question how it is that med science can identify possible 'skeletal' causes for Meniere's, causes which relate to purely stationery bone structures, bones which because they cannot move also cannot exert a mechanical influence on the surrounding tissues, but not mention the bone that resides in immediate proximity thereof which can in fact move, which can in fact exert a mechanical action on those same tissue, that bone being the Atlas, C1, the first vertebra. I mean, why, why would medical science stop at the mastoid? It is almost like there is an artificial barrier, perhaps even a political in one, that keeps medical science on their side of the line deviding the skull and soft tissue on the one side, and the spine on the other. There is enough evidence on this site alone that points directly to an upper cervical cause for Meniere's. The evidence is clear. So why, why will medical science not go there?...Why? I'm asking. Secondly, the article identifies, I believe correctly, three stages of the progression of the disorder: Stage I—In the early phase of the disease, the predominant symptom is vertigo. This is characteristically rotatory or rocking and is associated with nausea or vomiting. Signs of vagal disturbance, such as pallor and sweating, may occur, but loss of consciousness is not a feature. The episode is often preceded by an aura of fullness or pressure in the ear or side of the head and usually lasts from 20 minutes to several hours. Between the attacks hearing reverts to normal and examination of the patient during this period of remission invariably shows normal results. Stage II—As the disease advances the hearing loss becomes established but continues to fluctuate. The deafness is sensorineural and initially affects the lower pitches (fig 2(a)). The paroxysms of vertigo reach their maximum severity and then tend to become less severe. The period of remission is highly variable, often lasting for several months. Stage III—In the last stage of the disorder the hearing loss stops fluctuating and progressively worsens, both ears tending to be affected so that the prime disability is deafness (fig 2(b) and (c)). The episodes of vertigo diminish and then disappear, although the patient may be unsteady, especially in the dark. These stages make perfect sense and explain why folks who have had this disorder, even after they may have identified and corrected its cause, cannot get their hearing back. Essentially, at that point the tissue would be destroyed beyond repair. My guess is that stage III is what folks here refer as 'burnout.' Lastly, I thought that fig. four was particularly useful to help and understand the proximty of the various cranial nerves depicted. I expect that this picture was taken through a hole created in the mastoid during surgery. Notice that "The sectioned vestibular nerve (v) and the cochlear nerve (c) can be seen emerging from the porus of the internal auditory meatus. The facial nerve (f) is visible anteriorly and in the distance is the trigeminal nerve." All of these cranial nerves are extremely close together. They attach to the brain stem, just centemeters below where the picture was taken. So if one nerve might be affected by a skeletal actor, say a mislocated first vertebra, or what the heck, say the mastoid even though it cannot move, others could be as well. As I have indicated, this extreme close proximity of the vestibulocochlear nerve to the trigeminal nerve gives clues to explain how my Meniere's and my wife's trigeminal neuralgia could have the same basic cause. That was an excellent article for discussion. Thank you for bringing it to our attention. Hank
Will we all go through all 3 stages??? Anyone have any good stats on that? How discouraging! What a choice (not that we get to choose) - spin & puke, or be deaf. Do I need to start learning sign language and lipreading now? I'd say I'm maybe in stage II.
Excellent point made. I was thinking the same thing. Should I learn sign langauge and lip reading now in prepararation? I think I am still in stage one...I have made an appointment with Boston Eye & Ear, the soonest they can see me is October 7. How long is each stage suppose to last? Months, years??? I dread every day now.
I just read the whole thread. Great information! Thanx for posting this, I'm always learning more about this disease! G
