Tests & Medications for Menieres Disease
TESTS
Hearing Test (audiogram)
Hearing tests aredone in a sound-proof booth using headphones to test the patient's hearing in both sounds and speech. Several tones at different frequencies are sent to both ears to determine how much hearing loss if any has occurred. These tests will show whether or not your middle ear is working properly or not.
ENG (electronystagmography)
The purpose of the ENG is to determine whether or not the dizziness is due to inner ear disease. The 4 main parts of this test are calibration which evaluates rapid eye movements. The tracking test evaluates movement of the eyes as they follow a visual target. The positional test measures dizziness associated with positions of the head and the caloric test measures responses to warm and cold water poured into the ears.
ECOG (electrocholeography)
The ECOG test is a test where a recording electrode is placed as close as practical to the cochlea. It is intended to diagnose Meniere's Disease and particular, hydrops. The electrode consists of a golden sponge inserted into the ear canal, a wire or spring placed on the ear canal, or a needle that transfixes the ear drum. The objective is to measure the excessive fluid in the inner ear and it will also confirm the increased pressure present due to excess fluids in the inner ear.
Rotary Chair Test
The purpose of this test is to determine whether or not dizziness is due to a disorder of the inner ear or the brain. The three parts to this test; the chair test measures dizziness (nystagmus) while being slowly turned in the motorized chair. Persons with inner ear disease become less dizzy than do normal persons. The optokinetic test measures dizziness caused by viewing of moving stripes. The Rotary chair tests are the standard for diagnosis of bilateral vestibular loss.
Posturography
The Posturography test is a moving platform and is a method of measuring balance. It is most applicable in situations where balance needs to be followed to determine whether a disorder is getting better or worse, or the response to treatment.
Fistula Test
The purpose of this test is to detect perilymphic fistula, if pressure sensitivity is found, fistula is highly likely. Pressure is applied to each ear in turn eye movements are recorded with a sensitive infrared device.
The MRI (magnetic resonance imaging)
This test is similar to an xray except this test uses a magnetic field instead of an xray. It is not performed to diagnose mm but rather to diagnose other diseases such as Multiple Sclerosis, stroke or even tumors. Many times this test will include the use of chemical called gadolinium which is a dye that is injected directly into the vein through an IV. This helps to enhance the images that rule out other causes of dizziness problems.
ABR (auditory brainstem response)
The purpose of the ABR test is to determine if the hearing is abnormal but cannot be used to "rule in" Meniere's Disease. It can also be indicate an acoustic neuroma which is a benign tumor.
When the diagnosis of Meniere's Disease is eventually confirmed, treatment is directed at ending or markedly reducing the frequency and severity of attacks. Treatment includes modification of personal habits, diet, stress reduction and regular exercise--all extremely important in the overall treatment of Meniere's Disease. Medications will be recommended; evaluation of all treatments must be carefully annotated.
MEDICATIONS
There are many drugs that are used in the treatment of Meniere's Disease and you must remember what works for one person may not work for the next. This is a list of known drugs used to treat some cases of mm patients. Click on the underlined name and this will take you to more information on the particular medication:
Diuretics which are basically water pills, are taken to reduce excess fluid in the body. But caution must be exercised when taking this drug as it lowers blood pressure and depletes potassium levels. Dyazide (Triamterene-Hydrocholorothiazide).
Meclizine which is also known as Antivert and Bonamine is an over the counter antihistamine for nausea and dizziness associated with mm. It decreases the dizzy signals that are being sent to the brain and also works for some inner ear allergies.
Dramamine which is also known as dimenhydrinate, travel-tabs or Gravol. It is also an over the counter antihistamine used to stop nausea, vomiting and dizziness due to motion sickness. It is best to consult a doctor before taking this drug if you have other medical problems.
Benadryl which is also known as Diphenhydramine is an over the counter antihistamine that also works to stop nausea and vomiting due to motion sickness. You should talk to your doctor before taking Benadryl if you have other medical problems.
Transderm V Scopalomine Patch in not an antihistamine and is available through a prescription. It helps prevent nausea and vomiting of motion sickness. A patch is to be worn for 3 days and then removed. Most doctors do not prescribe this for treatment in mm because there are usually withdrawl symptoms.
Phenergan which is also known as Promathazine. It is both an antihistamine and phenothiazine and only available through a prescription. It is used to sedate the patient to stop the nausea and vomiting of Meniere's Disease.
Stemetil which is also known as Compazine is used for nausea and vomiting and is only available through a prescription also. This drug has side effects that include neck spasms or jaw jerking, agitation and the jitters.
Antidepressants - Sometimes are prescribed for patients to suppress vestibular symptoms or to help the patient cope with this chronic and sometimes debilitating illness. Some meds prescribed are Amitriptyline (Elavil); Zoloft; and many more that are available.
Are used in the management of anxiety disorders, insomnia, seizure disorders, skeletal muscle spasticity, alcohol withdrawl, panic disorder and as pre-medicants prior to surgical or diagnostic procedures. They have also been used in management of nausea and vomiting associated with cancer and vestibular disorders.
Valium which is also known as diazepam is usually prescribed to stop anxiety that some patients experience with menieres. It is described as a sedative for the vestibular system.
Xanax which is known as Alprazolam is also used to stop anxiety and vestibular symptoms.
Ativan also known as Lorazepam also is used to stop anxiety and vestibular symptoms. It is available in 2 forms, tablet and sublingual and is available with a prescription from your doctor.
Relief Band Device - is a drug-free treatment for nausea.
SERC
Which is also known as Betahistine hydrocholoride is the most common drug prescribed for Meniere's Disease. This drug improves the blood flow of the small blood vessels in the inner ear. The vasodilating properties of histamine were the basis for treatment of vertigo and other inner ear dysfunctions. It is available in over 70 countries around the world and is only available in the USA in compounded form. See the link below for more information:
Compounded Betahistine in the USA
(Note: Comments below are from a Menieres Sufferer who orders Serc from Switzerland)
Serc can also be ordered from an online pharmacy in Switzerland. This requires a prescription and any doctor in the USA can prescribe it (doesn't have to be a specialist). It comes in several different dosages; 8 mg, 16 mg and 24 mg tablets. You can order a 3-month supply at a time (just have the doctor write the prescription for the correct # of pills to last 3 months). This is how you order it:
For first time users or if it's a new prescription (when you run out of refills, you need a new prescription). Go their website
http://www.pharmaworld.com/frameset.php?v=1
Click on the "ordering" word on the left hand side of the page. Click on the order form and fill it out. Then you need to fax the order form and the prescription to the pharmacy. (The pharmacy now asks you to snail mail the original after faxing the order). Make a copy of the original prescription before mailing it to the pharmacy to keep for your file as sometimes customs asks you to fax a copy of the prescription to them. The fax number, phone number and address are all at the top of the order form.
For refills: go to their website and click on "use secure online order form". Type in all the information. Be sure to check the box that says the prescription was sent earlier (that lets them know if its a refill).
More information about Serc:
Ken Cornell's Serc Testimonial
betahistine_hydrochloride.html
