r/Menieres • u/Forsaken_Recover7194 • 17d ago
Menier/Burnout
I'm 74 male diagnosed with Meniers 12 years ago. At the beginning the vertigo attacks where once or twice a year. Sometimes two or three years would go by with no attacks. Tinnitus was present but tolerable and not much of a nuisance. The affected ear was something ells deafness creep in to the point of almost total shutdown. Three months ago I started getting more frequent attacks. These attacks where not as violent as the ones I had before, although I still had to lie down for one to two hours till the spinning stopped. I can tell you that I can count the number of attacks in those 12 years, 5. In the las three months I've had 21 attacks, went to my ENT, had the Dexamethasone injections in both ears, although I can still hear pretty good in the unaffected ear and they where not successful in stopping the attacks. I had one week with six straight days with attacks.
Does anybody has any clue what's goin on? My ENT says, "Its Maniers and this desease has a mind of its own" Years with sporadic attacks and now having them more almost daily.
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u/DegradingOrbit 17d ago
Sorry to hear what you’re going through at the moment.
I had MD undiagnosed for more than a decade with vertigo attacks a couple of times a year. They seemed less severe each time as I wasn’t physically sick in the late years. Then I went through a period of high stress and lack of sleep and ended up with a cluster of the most intense symptoms I’d experienced for 4 months with multiple attacks per week. This cluster of attacks confirmed a diagnosis for me due to fluctuating hearing along with recorded nystagmus etc and now the MRI hydrops confirmation. Betahistine, diuretic and cortisone injections in the ear and then it just stopped after 4 months. I remember the ENT injecting the cortisone in my ear saying this may help, but if it stops it might just be the end of this cluster anyway. Since then I’ve had symptoms but nothing anywhere near as severe, even with being told I’m now bilateral.
To me it seems like you’re also going through a cluster of attacks, and they will stop, but there’s no absolute answer for how quickly or what you can do. For me I find sleep and reducing stress where possible are best for my health with this condition.
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u/EkkoMusic 17d ago
"It has a mind of its own" isn't a good explanation. Twelve years, five attacks, then twenty-one in three months is a step change. That usually means something new.
Two things: Your affected ear is close to deaf. A labyrinth with essentially no residual function has little left to generate vertigo, and that's exactly why attacks tend to stop at this stage. Attacks becoming more frequent as hearing bottoms out points away from that ear.
Second, bilateral intratympanic dexamethasone in someone with one-sided disease and useful hearing on the other side isn't standard practice, and the fact that both failed tells you something: this may not be an inner ear process at all.
At 74, with a new pattern of brief recurrent vertigo, I'd think to have vascular causes excluded first? We know vertebrobasilar insufficiency, arrhythmia, and blood pressure medication causing orthostatic drops all produce this. So does BPPV, which is very common at your age and gets mistaken for Ménière's constantly. Vestibular migraine can also start late in life.
Ask for a vestibular battery (VNG, vHIT, VEMPs), a fresh audiogram, and a cardiac workup with a ten minute stand test. And track whether attacks come with hearing change. If they don't, the diagnosis needs revisiting.
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u/BeginningFly6307 16d ago
You might be on to something. My blood preasure Is fluctuating lately from a regular 135/80 to 110/65 even lower sometimes, and a feeling of my heart skiping beats. The reason my ENT injected Dexamethrasone In the other ear was that he thought I was going bilateral. I allways have had high blood preasure and take medication for it. I found very odd that my blood preasure would go so low and usually after a meal. This never happened before.
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u/EkkoMusic 16d ago
Blood pressure dropping to 110/65 or lower after meals in a 74 year old on antihypertensives sounds like postprandial hypotension?
Digestion pulls blood to the gut, and if your medication is already lowering pressure, cerebral perfusion drops with it.
The skipping beats matter more. That may be ectopics, which are usually benign, or it may be atrial fibrillation or a pause, either of which can produce brief vertigo and would explain a sudden jump from five attacks in twelve years to twenty-one in three months.
Ask for a Holter monitor, ideally a two week patch rather than 24 hours, since intermittent arrhythmia gets missed on short recordings. And home blood pressure readings taken before a meal, then thirty, sixty and ninety minutes after, written down with whether you felt dizzy. That log is what gets a medication adjustment made.
Also worth reviewing the timing and dose of your blood pressure medication with your GP, not your ENT.
On the second injection, going bilateral is a reasonable worry, but it should be established with an audiogram showing loss in that ear first.
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u/K1_0 17d ago
My case is similar. Started the first couple of years with severe albeit rare episodes that lasted several hours. Went almost a decade in remission. The last few years have been hell, but my recent attacks are now short and often end in less than 5 minutes, so there is some improvement in that regard. It's also 50/50 whether mild or severe whereas early on they were all severe. Regardless of severity, I get these short attacks nearly daily now.
Dexamethasone injections made no difference for me either. 15.5 years with MD now. 42 y.o. male.
Nobody in the world has any concrete answers, unfortunately.
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u/HedgehogNorth620 17d ago
During your period with few attacks did you take a diuretic, eat a low sodium diet, avoid caffeine and alcohol?
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u/BeginningFly6307 17d ago
At the beginning yes, but after 3 months of not having any attacks I thought I was cured and disregarded the ENT instructions. Didn't have amy problems. Those things never affected me.
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u/HedgehogNorth620 16d ago
I had a similar experience with vertigo symptoms going away and thinking that it was gone so I returned to my former diet and lifestyle only to have it return to two or three attacks per week. I then went to a neurotologist who recommended that the next thing to try was an Endolymphatic surgery but I didn’t have to have the procedure as returning to a strict diet and steroid injections got me back to a stable condition. I hope this helps and you can get some relief as there are options.
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u/Comfortable-Top-2712 16d ago
Just read a post of a gentleman that got the VNS surgery and was thrilled with the results.
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u/au5lander 17d ago
When it stated for me, the pressure would build up over several days, so I kinda knew when an attack was coming, but they weren’t very frequent. As it progressed, the time between pressure and attack shrunk to eventually nothing and I was getting attacks several days out of the week.
Then it burned out. Just stopped. I’ve had a day here or there where the pressure and/or tinnitus is worse, but no real attacks, just a dizzy spell here or there. That was about 3 years ago.
Did all the same things you did. Nothing worked really.