VERTIGO Demystified: Causes, Symptoms, and Effective Treatments

A disorder in the inner ear causes Meniere's disease. It deteriorates over time and causes poor performance at work, accidents, and psychological stress. It was first described about a century ago by the French doctor Prosper Meniere. It is characterized by several symptoms related to a disorder in the inner ear, which houses the sense organs for hearing and balance.

More than 96% of patients with Meniere's disease suffer from vertigo attacks. These attacks last from less than an hour to two days and may occur rarely, e.g., only once a year, or often, e.g., several times a year. After the attack, the patient feels completely exhausted and falls asleep; when he wakes up, he usually feels good.

Patients with Meniere's disease also have various hearing problems, with or without vertigo. The patient can, e.g., your hearing is gradually getting worse, you hear buzzing, buzzing, or ringing in your ears, or you feel that you hear a different sound in one ear than in the other; this phenomenon is called diplacusia.

Image: Meniere's disease usually occurs between 20 and 60.

Meniere's disease usually occurs between the ages of 20 and 60; the average age of patients is 40. However, children as young as four and older adults over 90 also fell ill. It usually starts in one ear and spreads to the other in many patients. Sometimes, for unknown reasons, the disease disappears by itself. Unfortunately, we cannot predict which patients will improve and which will not.

Inner ear defect

Meniere's disease is caused by fluid accumulation in part of the labyrinth or inner ear. The labyrinth contains three ring-shaped structures called semicircular canals. They are filled with fluid, which is necessary for a sense of balance and movement. Accumulation of this fluid impairs balance and causes dizziness.

Image: Fluid accumulation impairs balance and causes dizziness.

interior damage.jpg

Vertigo attacks can occur suddenly or after a short period of tinnitus or muffled hearing. Some people will have single attacks separated by long periods. Others may experience multiple attacks closer together over a few days.

Symptoms

Symptoms include:

Recurrent dizziness is sometimes accompanied by nausea, vomiting, pallor, and exhaustion.
Hearing problems, e.g., gradually decreasing hearing, ringing in the ears, the feeling that you do not hear the same in both ears.
The sensation of tension in the ears sometimes precedes an attack of vertigo.
Headache.

Consult your doctor if:

If you suspect you have Meniere's disease, a doctor must define it.
You have repeated vertigo attacks; balance problems can indicate an inner ear disorder that needs to be treated.
Your hearing is getting worse; gradual hearing loss is caused by a defect in any part of the ear (inner, middle, and outer) or the brain.
You hear a different sound in each ear; in addition to Meniere's disease, this is also a sign of other inner ear diseases.

Causes

Attacks of Meniere's disease are triggered by tension, anxiety, or excessive salt intake. Scientists are still debating the causes of the disease, but they know there is too much endolymph, fluid in the inner ear, or the labyrinth. The inner ear is two sensory organs compressed in the shadow bone, forming the skull's side. One part of the inner ear is the spirally shaped cochlea; it converts sound waves into electrical impulses and sends them to the brain.

The other part is three rings called semicircular canals. In these channels, a fluid flows according to the body's position (if you lie down, stand up, or lean to one side). From the signals coming from the channels and simultaneous data from the eyes and nerve endings in the skin, the brain determines the position of the body - whether it is vertical or horizontal. For an unknown reason, Meniere's disease causes too much fluid to build up in the inner ear, impairing the sense of balance. Sometimes, fluid accumulates here in the cochlea and causes hearing impairment.

Video content: Signs and symptoms of Meniere's disease.

Meniere's disease occurs more often in people who have an irregularly shaped inner ear or shadow bone - from birth or due to injury. The shape of the inner ear and the level of fluid in it can also be changed by some diseases and disorders, e.g., middle ear infection, syphilis, leukemia, otosclerosis (ossification of the middle ear), and immune disorders.

Diagnostic procedures

In most cases, an experienced otolaryngologist (ear, nose, and throat specialist) can diagnose Meniere's disease by talking about your problems and with a few simple tests carried out in the clinic. However, since many diseases cause vertigo and hearing problems - some minor, some quite dangerous - it is sometimes challenging to diagnose correctly.

To rule out other diseases, the doctor will examine you thoroughly. Some of the tests he may order are audiometry, which tests hearing; x-rays to show the shape of the skull and any old injuries; electrocochleography, in which an electrode is inserted through the eardrum and the electrical characteristics of the inner ear are measured; which indicates the nature of hearing problems.

Treatment

Scientists have not yet discovered a cure for Meniere's disease, so treatment aims to alleviate the symptoms and mental effects. Surgery is the last resort for patients with a very severe disease.

Conventional medicine

Treatment of Meniere's disease begins with drugs that reduce the pressure and amount of fluid in the inner ear. They usually prescribe diuretics (increase fluid excretion) and sedatives (sedate the patient and reduce dizziness). Meclizine and diazepam are often prescribed to reduce vertigo; some doctors also use antihistamines, e.g., promethazine and dimenhydrinate.

Image: Treatment is aimed at alleviating symptoms.

meniere's disease.jpg

Recently, patches with scopolamine, which are used for seasickness, have also been recommended. These drugs help some patients, but scientific research does not unanimously support their use. Many of these drugs can cause unwanted side effects, and none cure the disease.

Some doctors also prescribe treatment in a "pressure chamber" - they want to improve the pressure in the ear by changing the external pressure. They have also developed a series of operations aimed at deliberately destroying the inner ear's labyrinth to stop vertigo. The surgical techniques are vestibular neurectomy, in which the nerves that go to the balance part of the inner ear are cut, and labyrinthectomy, or removal of the maze.

These drastic procedures, which severely impair balance and destroy the hearing aid, are only performed on patients with severe vertigo. In another operation, called endolymph sac surgery, the surgeon tries to preserve hearing and balance; pressure in the inner ear is reduced by draining the labyrinth or inserting small valves or bypasses. The results are good in the first year after the operation; in some patients, dizziness reappears later.

Alternative ways

Like most conventional medicines, alternative medicines try to reduce stress and other symptoms.

Acupuncture

If you have vertigo, consult a specialist about stimulating the following ear points: nerve, sympathetic, kidney, occipital, adrenal, and heart. For chronic problems, the acupuncturist can work on the points of the kidney meridian, triple heater meridian, and spleen meridian.

Aromatherapy

Prepare a bath with lavender, geranium, and sandalwood essential oils to reduce stress. Also, try a gentle massage with lavender extract or chamomile oil.

Working with the body

If you have chronic Meniere's disease, consult an osteopath or chiropractor about manipulation of the head, jaw, neck, and lower back - limited mobility in these parts of the body can affect the inner ear. In an acute attack of Meniere's disease, the reflexologist may recommend a massage of the ear area of the foot; this and other areas that may be useful are painted on the right in the box.

Chinese herbs

Some experts in Chinese medicine distinguish between types of vertigo. The general multipurpose remedy contains Siberian thistle (Xanthium sibiricum), magnolia (Magnolia liliflora), Ural licorice (Glycyrrhiza uralensis), Japanese dogwood (Lonicera japonica), and other herbs. See a Chinese medicine specialist to prescribe the right medicine. Keep in mind that allergies to some Chinese herbs are possible.

Homeopathy

A patient with Meniere's disease can choose various homeopathic medicines - all taken in the active ingredient 12x every 4 to 6 hours. Try Bryonia for vertigo during an acute attack, worse on motion, accompanied by headache and humming or buzzing in the ears.

Video content: Natural treatment of Meniere's disease.

For dizziness and nausea during an acute attack, use cocculus. But for vertigo, which is worse by lying down or turning on the other side and is accompanied by sensitivity to light, take conium. If you do not feel better after a day or two or have chronic Meniere's disease, consult a homeopathic specialist.

Reflexology

Reflexology is an alternative treatment that can be used in the Meniere's disease community.

Image: Reflexology can help you feel less stressed.

To relieve symptoms, stimulate the ear area by running your thumb along the bases of the last four toes and in the hollow of the second and third toes. Also, run your thumb up and down the upper spine area and work the neck area on your thumb. Then, stimulate the area of the solar plexus.

Medicine of mind and body

With Meniere's disease, patients find themselves in a vicious circle: attacks cause stress and anxiety, which can trigger an attack. Patients can join self-help groups where they can discuss their problems. You can also effectively reduce stress with different types of massage and yoga.

Nutrition

Some nutritionists recommend a diet high in calories, fat, and protein for Meniere's disease, although there is no evidence that this can cure the disease. Specialists recommend daily consumption of 2000 mg of vitamin C, 50 mg of vitamins Br/ B and B6 each, 20 mg of zinc, and other minerals and vitamins. If you have Meniere's disease, avoid salt - which causes the body to retain water - and limit your fluid intake.

Some experts assume that reducing the amount of fluid in the body reduces the pressure in the inner ear, but this has not been proven. A dietitian can help you put together a diet for your specific problems.

Home treatment

Try to get a good night's sleep.
During an attack of Meniere's disease, lie still and try to relax.
Try to consume less salt and liquid; some believe that reducing the amount of fluid in the body reduces the pressure in the inner ear.
Don't consume caffeine and alcohol, and don't smoke because all this increases stress and prevents quality rest.
Avoid driving, swimming, climbing ladders, and other activities where you could seriously injure yourself during a vertigo attack.

Prevention

The best way to prevent an attack of Meniere's disease is to reduce stress. Do things that make you happy, e.g., do some hobby or sport. Make time for activities that make you happy: listen to music, take a relaxing bath, read a magazine, drink a calming tea - chamomile (Matricaria recutita) is a good choice - or sit and do nothing.

Video content: What is Meniere's disease?

If you continue to have problems with stress and anxiety, it may be a good idea to consult a psychotherapist.

Questions and answers

What causes vertigo?

Problems with the inner ear that affect balance are the most common causes of vertigo^[1].

What is Meniere's disease?

Meniere's disease is a disease of the inner ear that causes spontaneous episodes of vertigo and occasionally hearing loss, ringing in the ear (tinnitus), and sometimes a feeling of pressure in the ear. In most cases, Meniere's disease affects only one ear^[2].

How do we treat vertigo due to Meniere's disease?

Your doctor may prescribe medication to take during a vertigo attack:

medicines against motion sickness
anti-nausea drugs
diuretics and betahistics^[3]

What are the symptoms of Meniere's disease?

Symptoms include:

Recurrent dizziness is sometimes accompanied by nausea, vomiting, pallor, and exhaustion.
Hearing problems, e.g., gradually decreasing hearing, ringing in the ears, the feeling that you do not hear the same in both ears.
The sensation of tension in the ears sometimes precedes an attack of vertigo.
Headache.

How common is Meniere's disease?

The incidence of Meniere's disease worldwide varies widely, from 3.5 to 513 per 100,000. According to the AAO-HNS, "Meniere's disease is almost exclusively seen in adults, and less than 3 percent of cases are thought to occur in children under 18^[4].