Preliminary list of scientific studies of Viruses and MM Part 1 of 3

Discussion in 'Meniere's Disease "Database"' started by Papajoe, Oct 26, 2009.

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  1. Papajoe

    Papajoe Myco-dental Freak of Nature

    UPDATE: Here is the most up-to-date version of the posting, with permanent links to the .pdf documents:,22821.msg403200.html#msg403200

    This is the original posting:

    Since MM is ideopathic (meaning, they don't know what causes it) treatment for MM has traditionally focused on reducing the symptoms. This often takes the form of low-salt diets, medication to suppress vestibular balance (valium, antivert, etc) and to deal with the anxiety (valium, xanax, anti-depressents). More aggressive treatment of symptoms include steroids (both oral and in-ear injections) and the most radical treatments include destroying the inner ear's functionality with Gent injections, or nerve resections.

    It is likely that MM can occur for any of a number of reasons. I have come to believe, over the past week, that my problem is an allergy to wheat (not gluten, but wheat itself). For years, scientists have suspected a viral etiology (cause), usually with one of the Herpes Simplex Virus (HSV) or the Herpes Zoster Virus (VZV).

    I have compiled a list of all of the studies I could find on PUBMED, a listing of scientific papers provided by the US National Institutes of Health. Being included on this list does not mean that the NIH approves of the conclusions that each study reaches, it's just a listing. Scientific studies are only as good as the care that goes into them. Just because a scientific paper says viruses may be the cause, or says that viruses aren't the cause, doesn't make them valid. You have to look at the methodology, which is beyond the scope of my list. However, if you take them as a group, far more studies support a viral etiology than the studies that find no evidence of a viral etiology.

    In my list, there are 40 studies that support a viral etiology of MM. Five of them were equivocal (meaning, they neither prove nor disprove) and six were found to not support viruses as a cause. In it's entirety, I believe that a viral etiology is supported by the scientific literature, at least for some patients. It is important from a scientific viewpoint, if you plan to use this to convince your doctor, that you include the studies that don't support viral causes along with the ones that do.

    Due to the posting limit, I'll post this list in two parts. The first part is a list of scientific studies that are equivocal and those that do not support a viral etiology of MM in some patients. The second part will be the studies that do support a viral etiology of MM.

    In another week or so, I'll put together an entire document that contains both lists, plus the results of my anti-viral Poll,22504.0/viewResults.html with a list of testimonials which will be suitable for sending to your doctor.

    So far, the overwhelming majority of the poll-takers have found benefit from anti-virals. It does appear that anti-virals work best when prescribed early, before permanent damage occurs. No drug can reverse permanent damage, and long term sufferers may not see as much benefit from anti-virals.

    Here are the Equivocal and Non-Supported studies:

    Randomized double-blinded, placebo-controlled clinical trial of famciclovir for reduction of Ménière's disease symptoms.
    Otolaryngol Head Neck Surg. 2004 Dec;131(6):877-84
    SIGNIFICANCE: Famciclovir may suppress the fluctuation of hearing in Meniere's disease, but had a minimal effect on vertigo or dizziness symptoms in this study. The probable multifactorial etiology in Meniere's disease requires that further studies be conducted to determine the effects of antiviral medications.
    Viral culture and electron microscopy of ganglion cells in Meniere's disease and Bell's palsy.
    Acta Otolaryngol. 1978 Sep-Oct;86(3-4):269-75
    At present there is no proof that viruses are present in Scarpa's or geniculate ganglions but the possibility remains that the inclusion bodies observed might be viruses inactivated inside the ganglion cells.
    Incidence of virus infection as a cause of Meniere's disease or endolymphatic hydrops assessed by electrocochleography.
    Eur Arch Otorhinolaryngol. 2005 Apr;262(4):331-4. Epub 2004 Jul 2.
    In MD patients, the IgG titre against VZV and ADV were significantly higher than in the control (schwannoma) group. However, no correlation was found between the IgG levels against ADV and VZV with the SP/AP ratio. Neurotropic viruses such VZV and ADV may play a role in the pathogenesis of MD, despite the absence of association between the levels of IgG titres and the SP/AP ratio.
    Peripheral vestibular disorders with acute onset of vertigo.
    Curr Opin Neurol. 2002 Feb;15(1):5-10.
    In acute vestibulopathy, suspicions of the activation of herpes virus infections as a causative agent are increasing, but no reports on the treatment of such infections are yet available.
    Herpesvirus DNA in peripheral blood mononuclear cells of some patients with Meniere's disease.
    Microbiol Immunol. 2001;45(9):635-8.
    These findings may imply that reactivation of HSV- 1 or VZV may be associated with the development of some cases of Meniere's disease.
    Viruses and vestibular neuritis: review of human and animal studies.
    Acta Otolaryngol Suppl. 1993;503:70-3
    However, animal studies have demonstrated that several human viruses including rubeola, herpes simplex, reovirus, mouse and guinea pig cytomegalovirus, and neurotropic strains of influenza A and mumps virus, can infect the vestibular nerve and the vestibular membranous labyrinth.

    Herpes virus and Ménière's disease.
    ORL J Otorhinolaryngol Relat Spec. 2008;70(1):28-31; discussion 31. Epub 2008 Feb 1
    Based on these results, reactivation of HSV1 and VZV in the vestibular ganglion does not seem to play a role in the pathogenesis of MD. (c) 2008 S. Karger AG, Basel
    Intratympanic application of an antiviral agent for the treatment of Ménière's disease.
    ORL J Otorhinolaryngol Relat Spec. 2008;70(1):21-6; discussion 26-7. Epub 2008 Feb 1
    In conclusion, most patients were improved after the intratympanic injections, but there was no obvious difference between the treated and control groups. The benefit might be due to the middle ear ventilation or reflect an improvement in the patients' emotional state. (c) 2008 S. Karger AG, Basel
    Viral infection and serum antibodies to heat shock protein 70 in the acute phase of Ménière's disease.
    Int Tinnitus J. 2007;13(2):90-3.
    We found no relationship between the presence of antibodies to HSP70 and immunological or viral testing.
    Detection of viral DNA in vestibular ganglia tissue from patients with Menière's disease.
    Am J Otol. 1997 Nov;18(6):734-7.
    CONCLUSIONS: In patients with MD requiring surgical intervention, infection with herpes simplex virus, cytomegalovirus, or varicella zoster virus of the vestibular ganglia does not appear to play a major role in the pathoetiology of the disease.
    [Does virus diagnosis open new ways for the classification and treatment of sudden deafness, unilateral vestibular loss and idiopathic facial paralysis?]
    HNO. 1986 Sep;34(9):376-8.
    So viral etiology of sudden deafness, acute vestibular loss and Bell's palsy seems to be unlikely and does not change the assignment and therapy of this disease.
    [Possible viral etiology of inner ear diseases (author's transl)]
    Laryngol Rhinol Otol (Stuttg). 1981 Nov;60(11):591-2
    Therefore we refute a relation between viral infection and inner ear troubles; for a practical point of view virological diagnostics is not indicated.
  2. vasu

    vasu New Member

    Thank you papajoe for compiling this. This is very helpful. Your final document should be put in the Database section.
  3. Henrysullivan

    Henrysullivan New Member


    I apologize that I have been remiss in paying attention to this very imformative post you placed back in October. I see that this was to be 1 of 3; but I do not see parts 2 and 3 of 3. But I will comment on what I do see here do far.

    Lately, I have been placing a little thought toward the viral causes of Meniere's symptoms. For some time now, it has occurred to me a certain strangeness in the fact that upper cervical-related Meniere's symptoms and viral related Meniere's symptoms could be so similar in nature. On the surface, that just does not make much sense. But the fact that it doesn't make sense, I believe, may be a large clue regarding how it is that these two etiologies (I like that term, Papajoe) could result in vitually identical symptoms.

    To answer this strange coincidence with sense, it occurs to me to try to understand what it might be that both of these etiologies have in common. Well, that is evident, the 8th cranial nerve, the hearing and balance nerve. The theoretical model I have constructed that explains 'chiropractic' Meniere's symptoms predicts that an impingement on that nerve's pathway to the brain causes either (1) damage to the nerve, decreasing its effectiveness to service the tissues of the inner ear, or (2) simple impingement of the nerve, without necessarily damaging it, but resulting in a decrease in its ability to serve the tissues nonetheless. Either way, mechanical action on the path that provides information to pass to and from the brain and inner ear causes information to be corrupted. When that occurs, the tissues serviced by that nerve, AKA, the inner ear tissues, for that lack of innervation, atrophy. And because they atrophy, they lose their properties. And one strategic area of concern would be the endolymphatic sac, what I believe is responsible for the passing of old endolymph away from the inner ear to be recycled to the body. Briefly, as the sac enlarges, the membranous walls of the sac decrease in thickness, allowing endolymph to pass through. As the flow of endolymph slows, the sac shrinks, the walls thicken, and enough endolymph is retained to maintain positve pressure in the passageways. If, by virtue of a lack of innervation, sac tissues lose their properties of permeability, then endolymph will be retained in the vestibular area long after it should have been allowed to recycle. The sac swells, yielding the symptom of aural fullness that many here are familiar with. This makes perfect sense. I say that because cell replacement is a function regulated by the brain. If a certain area of the body cannot communicate with the brain, then the brain cannot send vital nutrients to tha area to support cell replacement. As a result, cells die faster than they are restored, atrophy occurs.

    That brings me to the viral etiology. If two subjects have the same Meniere's symptoms that would come from the atrophic action of tisses to which I refer above, but one has a viral cause and one has an upper cervical cause, then that can only mean that these two causes result in the same conditions developing in the inner ear, I hypothesize the endolymphatic sac for one. Corresponding with JOH the other day, suspecting what I would hear from him, I left with the understanding that it is not necessarily viral activity on the inner ear tissies directly that would bring on the symptoms about which we speak. But instead it was viral activity on the 8th cranial nerve, the hearing and balance nerve, that decreases that nerve's capacity to serve its function, that causes the same sort of atrophic action to take place in the inner ear, causing for one thing, the endolymphatic sac to lose its elasticity and its transmissive properties. John allowed that this is distinctly possible recalling an onset of viral facial paralysis that he had experienced, Bell's Palsy, which did in fact decrease the ability of the facial nerve, one of 12 cranial nerves just like the hearing and balance nerve, to work. This causes atrophy of the facial muscles and an inability of the muscles to perform their functions. But the virus responsible for Bell's Palsy did not infect the facial tissues, only the nerve. The same, I expect, is what we should expect with the tissues of the inner ear. And that is why I believe that your research is so valuable posted here, Papajoe. And interestingly enough, one of the studies you brought forth cites Bell's Palsy as a corresponding condition to Meniere's.

    So according to these studies posted above, no evidence of viral infections could be found in the tissues of the inner ear of the subjects examined. But with what I have allowed above, that is exactly what I would expect. No, the virus would not be in the tissues, only in the nerve serving the tissues. If the virus were in the tissues, then what would keep the virus from moving on to the next closest tissues? I mean, the brain is right there, why not the virus attack the brain. No, I think it is clearly probable that the etiology (oooh, I like that term, Papa!) of both of these subjects result in the same symptoms because both work to impede the hearing and balance nerve from functioning properly. As a result, no matter which causes the nerve to cease functioning, the tissues if the inner ear, starting from the most remote tissues, those being the tissues of the endolymphatic sac, atrophy, bringing about fullness. The swelling of the tissues places pressure on both other tissues and the hearing nerve itself causing a certain manifestation of tinnitus. And when the sac finally breaks open, allowing endolymph to escape comparitively rapidly, that brings about vertigo.

    Now what I refer to here is not meant to explain every case here, only certain cases that have either a viral or an upper cervical cause. But this explains so much. To imagine that these causes could manifest the same symptoms but for unrelated reasons, is too extravagant to be relevant. But this makes perfect sense with what I know today.

    Thanks, Papajoe, for bringing this information to us. This is why this website is so important. This is where the cutting edge science is happening in Meniere's, no where else. This is where a bunch of motivated and intelligent folks, who have the experience of Meniere's symptoms in their distinct recollections, place their best talents and efforts toward understanding these symptoms and their causes, and work together from different angles to understand and treat these symptoms that cause so many folks all over the world to suffer. I am very proud to be here among such great folks.

  4. Jordan

    Jordan New Member

    Here is the rest of the info:

    Papajoe's three-part list of scientific studies on the relationship between Meniere's and viruses:

    Part I:,22570.0.html

    Part II:,22571.0.html

    Part III:,22572.0.html

    This information is also available in PDF format:
  5. KatiePA

    KatiePA New Member

    This is fascinating, thanks for your efforts in putting it together. Your theory (and Hank's efforts to reconcile it with the cervical theory) make so much sense to me. I'm wondering whether there is a tie between "going bi" and etiology. For example, are those of us with cervical problems more likely to be affected only on one side, and those with viral or other systemic rather than mechanical causes more likely to eventually go bilateral? I have no understanding on a cellular level of how a virus attacks a nerve, perhaps someone who does might have more to say about this. Just popped into my head, thought I'd raise it out of curiousity.

  6. Henrysullivan

    Henrysullivan New Member

    That is a great point, Katie. Whereas, for folks with cervical causes, I would think that going 'bi' would be almost the luck of the draw. It would just depend on whether that nerve on the opposite side, or that nerve pathway in the branstem on the opposite side, would be affected by the misalignment. It could be, but would not have to be. But if what I am saying is halfway right, then because the viral component would have to infect two nerves, on opposite sides, and no other of the 12 cranial nerves nearby, then I would imagine that the odds against that would be much greater. You make an excellent observation, one I doubt would have occurred to me. That is why it take all of us to figure this stuff out.
  7. Taximom5

    Taximom5 New Member

    Brilliant, Papajoe! Thanks for compiling and posting.

    I wish the doctors would bother to research the way you do...
  8. chefbrinson

    chefbrinson New Member

    Thank you so much Papajoe for taking the time to research and document this. I just joined this site and it feels good to know there are intelligent people working to find answers.
  9. hollymm

    hollymm Me, 'in' a tree.

    I noticed that Jordon was kind enough to give all three parts within this one posted topic. Much appreciated Jordan. I hope you pick up on this papajoe. I'm having a bit of a hard time understanding all the verbiage of the studies. I'm not very good at understanding the words used. I know I could look them all up for years and, hopefully understand them. What I'm hoping for is what your conclusion was/is with the additional time you've had to study about Meniere's and understand more about this affliction we all share. I see you have started topics on different things and don't know if the basis comes from this particular study or not.

    I'm seeing from both Hank and John, I think anyway, support in your efforts to finding out the basic etiology of Meniere's. I guess what I'd like to ask of you is what is currently your thought on the information you provided in your three part topic and further studies if possible.

    I really did try hard to understand it all but it's written for someone who has a basic knowledge of all the terminology used in the excerpts.

    Please? With sugar and a cherry on top (or not)?
  10. Jordan

    Jordan New Member

    Hi Holly,

    I am sure Papajoe will be along to answer your questions but I thought I'd explain what the significance of these studies is for many people here. Basically the studies show that herpes viruses may be the cause of Meniere's in many people. If that is the case, then one can be successfully treated with antiviral medication like Acyclovir. My husband was successfully treated with this medication and no longer suffers from the ugly symptoms of Meniere's. This is something I wrote about in this thread, which contains more information and resources:,23217.0.html

    The problem is that many doctors still reject the idea that Meniere's can be caused by a herpes virus, or that antiviral medications will have any impact. Many doctors won't prescribe the medication even though it is relatively benign. Papajoe was kind enough to compile all these studies so that people can print them and show them to their doctors. Many people on the forum have had success with antivirals, including June, Caribbean, Funshine, Capsized, MamaBear, Winewench and many others. Others have used L-Lysine (as recommended by John of Ohio) and have experienced relief as well. L-Lysine is a supplement that can suppress herpes viruses but it may take longer to work than prescription-strength antivirals.
  11. hollymm

    hollymm Me, 'in' a tree.

    OK, I am taking hand notes now!! I don't have a copy machine so hand-written it is!
  12. Taximom5

    Taximom5 New Member

    Holly, if you can get to a library, maybe you can print out a few pages or even threads so that you don't have to write out by hand?
  13. hollymm

    hollymm Me, 'in' a tree.

    That's definately somewhere to go. right now I'm basically taking one word hand notes and may,later put a small note by it when I find the answer that works for me. It's all the information given throughout the web that's pertinent to me and my particular situation. If I print something that I can't understand anyway, I have nothing concrete to go on. Now the info that was put out in this three part series may be interesting to my doctor but lenghty - time wise - for him to go through. I need quick feedback on a wide variety of issues to bring up to him/them. Or maybe I'm not giving my doctors enough crediit for being interested enough to go through it all.

    I might meet with the same thing Jordan is talking about - their refusal to listen beyond their own present knowledge (sorry Jordan if I read it wrong).
  14. Papajoe

    Papajoe Myco-dental Freak of Nature

    I rarely come to the database, I should come by more often. I updated the original post below (above?) with links to most recent info.

    If you can get your doctor's e-mail address (or even just the e-mail address of the office), you can e-mail him the two .pdf files that made up the documents. That's what I did with my OTO.
  15. Papajoe

    Papajoe Myco-dental Freak of Nature

    The two .pdf files associated with the posting are concise and written in "doctor speak". The main thing that you, as the patient, need to understand is the the articles listed in the the pubmed links (and in the .pdf docs) are the same scientific articles that the doctor reads in his/her medical journals. They are peer reviewed. That means other doctors/scientists have looked at the study and agree it's not flawed in any fundamental way. It does not mean they agree with the results, just that it's a valid experiment.

    The reason there are so many studies listed is that rarely does a single scientific study provide a "smoking gun", so you have to show the doctor that there has been a lot of study, and that the studies overwhelmingly support the idea that a virus is involved. Most doctors will at least pay attention to the studies. Any doctor that would reject this info out of hand needs to be avoided.

    Papa Joe
  16. Taximom5

    Taximom5 New Member

    Please read (or reread) first post in this thread and also parts 2 and 3.

    It should also be noted that Papajoe has never charged a penny for this information!
  17. hollymm

    hollymm Me, 'in' a tree.

    He's also always been there to answer any questions and support anyone who might need it. Papajoe, you are a very special person along with Taximom, JOH, Hank and so many - all so willing to give to us, over and over again. Special blessings (I don't mean in a religious fashion either) go out to you.
  18. Taximom5

    Taximom5 New Member

    Papajoe rocks!

    Holly, I bumped the viral info corresponding threads in The Living Room section, too, to make them easier to find (there's a part 2 and a part 3).
  19. Gina05

    Gina05 Guest

    Yep, I think Papajoe rocks, too. :)

    Thanx for these posts, very informative.
  20. hollymm

    hollymm Me, 'in' a tree.

    Thanks TM - much appreciated :)

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