I thought it would be useful to remind everyone, especially newbies, that MM is still considered to be an idiopathic disease. This means that no one knows what causes MM. There is no single test or diagnostic procedure that definitively points to MM. Before diagnosing MM, a physician should have ruled out all the mimics of MM including labyrinthitis, cervical causes (neck), autoimmune diseases, fistulas, migraine … Once the doctor is satisfied that she can not explain your symptoms in terms of known diseases or malformations, then the doctor may dx MM. If you read things on this site that you feel your doctor missed, you should ask your doctor if she has ruled out these possibilities. No doctor is ever perfect and besides, diagnosing inner ear disorders is not easy. As an example, many people, who were initially diagnosed (tentatively?) with MM, end up having migraine associated vertigo MAV. May we all have accurate diagnoses. Joe
Very good post... my case was different because I suffered a head trauma and developed all the symptoms shortly after that. Alot of ppl don't realize that MM can be caused by have a head injury and wouldn't possibly associate the two. again... very good information. thanks Gina
Some day....some day....this will not be idiopathic. The increases in MRI resolution will be one of the keys for a definitive diagnosis, and more razor sharp testing from various angles can help in finding what are most likely multiple causes of this disease. When that will be.....is anyone's guess.
I just wanted to add that nutritional deficiencies (B12, vitamin D, and probably others that I don't know) need to be ruled out, as well as food sensitivities, particularly gluten and casein. Unfortunately, every doctor I saw either smirked or laughed at me when I asked that we rule these out. I was then offered: diuretics, prednisone, a cortisone shot in the ear, and strong migraine medication. (Do we have a disgusted-looking emoticon??)
Joe, do I understand you to say then that until somone's attending physician has ruled out cervical causes, then a Meniere's diagnosis would be erroneous? If that would be the case, then until such a physician refers his or her patient for an upper cervical examination, then he or she would be incorrect to diagnose Meniere's. Is that not right? Well, how many doctors of Meniere's sufferers on this site have sent their patients to a chiropractor? And since the vast majority of folks on this site who have a Meniere's diagnosis have not been to the chiropractor, then are they presently misdiagnosed? Don't get me wrong; I sort of agree with you if what I ask is what you are saying. Is that what you are saying? Hank
Hank, It would not necessarily be an erroneous diagnosis; rather, I would say it was a premature diagnosis. I do not believe it is necessary to see a chiropractor to determine if neck issues are causing MM symptoms. I suspect most neurotologists check for neck issues in their own ways. (You can see Dr. Hain’s comments on this in his website.) Diligence in ruling out the mimics leads to more accurate diagnoses of MM. However, I am sure doctors also have to use the common sense that they’ve acquired over the years. There are financial limits. Hope you are feeling well and in good spirits, Joe
Yep, Joe, I'm in fine spirits. I hope you are and thanks for the response, very much. Of course, you know my concern here. And just as I can find no reference on Dr. Hain's flowchart that even regards upper cervical causes for these types of symptoms, that is, Meniere's symptoms, I doubt that many other doctors, neurotologists or otherwise, regularly consider upper cervical abnormalities as potential causes either. I bet that if you asked folks on this website if their neurotologist did any testing for upper cervical abnormalities, which tests would amount to a series of x-rays complete with the training to interpret them, the vast, vast majority would tell you that they have no recollection of such. So there you go. In the vast, vast majority of cases, according to your reasoning, and I agree with it, the Meniere's diagnosis is without standing because, as you say, it is premature. I find it interesting, and I have voiced this before, that only as long as one does not know what is causing one's Meniere's symptoms, can one be 'correctly' diagnosed with Meniere's. But as soon as that very same person, previously diagnosed with Meniere's, discovers the cause, then all of a sudden he or she no longer has Meniere's. One minute you do, the next you don't. How can that be? It is like one of the requisite symptoms associated with the Meniere's diagnosis is a certain degree of ignorance. One must be ignorant of the cause of one's symptoms in order for those symptoms to amount to a diagnosis of Meniere's. So somewhere on Doctor Hain's flowchart there should be the question asking whether the patient is actually ignorant of the cause of his or her symptoms. Answering 'yes' leads to the diagnosis of Meniere's. Answering 'no' leads to something else. So in a certain sense, ignorance itself is a symptom of Meniere's, ignorance of the cause of the other Meniere's symptoms. Doesn't that sound really strange and circular, that in addition to all the classic symptoms, one must also be ignorant of the cause to be diagnosed with Meniere's? Some folks lose patience with me on these kinds of discussions. I understand that. And thank you for yours, Joe. But I raise these issues not to argue a point. I raise them to elevate the awareness of folks to the mindset of their physicians. If physicians are not going to even consider a certain realm of possible causes of their symptoms, which as a standard course Dr. Hain's flowchart helps to clarify that they may well not, then it must be up to the patient to fill in the ignorance gap required of the Meniere's diagnosis with knowledge. Folks have to educate themselves with certain knowledge if they are to have any hope to remedy their Meniere's symptoms. Thanks, Joe. Your post was very useful to help develop a point that I hope will help a certain number of receptive folks who might read it. Hank
NOBODY (not the neurologist, not the 2 ENT's, not my primary care physician) considered cervical issues, even though I had been in an accident with severe trauma to the shoulder, and had been complaining of neck pain and stiffness for some time. Even my chiropractor didn't think of Meniere's--until I mentioned both the diagnosis and Hank's thread (which I copied for him), and then he said, "of course," and worked some magic on my neck. No symptoms since then--and I have also been trying to follow John of Ohio's regimen, as well. Hank, I for one have not lost patience with you--I'm very grateful that you keep bringing this up and pushing things!
