PHT Live – Vestibular Neuritis and Meniere’s Disease

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Do you or a loved one suffer with vertigo?  Today we will be discussing two of the most common causes of vertigo, Vestibular Neuritis and Meniere’s disease.  New information from scientific journals is associating both of these conditions of the inner ear to be caused by the immune system.  We will discuss how these conditions come about and how they lead to disabling vertigo, but also the underlying mechanisms which set them off.  Lastly, we will discuss rehabilitation for both of these conditions.
Therefore, tune in and enjoy.  Please forward us any questions at www.powerhealthtalk.com or go to our Power Health Facebook page http://powerhealthreno.com/Facebook

 

1. Is vestibular neuritis an immune related vestibular neuropathy inducing vertigo?
Greco A, Macri GF, Gallo A, Fusconi M, De Virgilio A, Pagliuca G, Marinelli C, de Vincentiis M.
J Immunol Res. 2014;2014:459048. doi: 10.1155/2014/459048. Epub 2014 Jan 15.
PMID: 24741601 [PubMed – in process] Free PMC Article
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2. Bell’s palsy and vestibular neuronitis.
Royal W 3rd, Vargas D.
Handb Clin Neurol. 2014;123:763-70. doi: 10.1016/B978-0-444-53488-0.00037-7.
PMID: 25015516 [PubMed – in process]
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3. Vertical components of head-shaking nystagmus in vestibular neuritis, Meniere’s disease and migrainous vertigo.
Kim CH, Shin JE, Song CI, Yoo MH, Park HJ.
Clin Otolaryngol. 2014 Jul 15. doi: 10.1111/coa.12286. [Epub ahead of print]
PMID: 25042770 [PubMed – as supplied by publisher]
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4. A quantitative analysis of gait patterns in vestibular neuritis patients using gyroscope sensor and a continuous walking protocol.
Kim SC, Kim JY, Lee HN, Lee HH, Kwon JH, Kim NB, Kim MJ, Hwang JH, Han GC.
J Neuroeng Rehabil. 2014 Apr 11;11:58. doi: 10.1186/1743-0003-11-58.
PMID: 24725764 [PubMed – in process] Free PMC Article
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5. Clinical implication of ocular torsion in peripheral vestibulopathy.
Choi JW, Kang SI, Rhee JH, Choi BY, Kim JS, Koo JW.
Eur Arch Otorhinolaryngol. 2014 Mar 8. [Epub ahead of print]
PMID: 24609644 [PubMed – as supplied by publisher]
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6. Corticosteroids and vestibular exercises in vestibular neuritis. Single-blind randomized clinical trial.
Goudakos JK, Markou KD, Psillas G, Vital V, Tsaligopoulos M.
JAMA Otolaryngol Head Neck Surg. 2014 May;140(5):434-40.
PMID: 24604142 [PubMed – indexed for MEDLINE]
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7. Postural control in patients after a recent vestibular neuritis with hyperhomocysteinemia.
Raponi G, Teggi R, Gatti O, Giordano L, Bussi M.
Indian J Otolaryngol Head Neck Surg. 2013 Apr;65(2):146-50. doi: 10.1007/s12070-012-0610-x. Epub 2012 Dec 20.
PMID: 24427555 [PubMed] Free PMC Article
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8. Vertical eye movements during horizontal head impulse test: a new clinical sign of superior vestibular neuritis.
D’Onofrio F.
Acta Otorhinolaryngol Ital. 2013 Dec;33(6):418-24.
PMID: 24376299 [PubMed – in process] Free PMC Article
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9. [Intratympanic corticosteroid perfusion in the therapy of Meniere’s disease].
Sankovi?-Babi? S, Kosanovi? R, Ivankovi? Z, Babac S, Tatovi? M.
Srp Arh Celok Lek. 2014 May-Jun;142(5-6):291-5. Serbian.
PMID: 25033583 [PubMed – in process]
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10. Higher Prevalence of Autoimmune Diseases and Longer Spells of Vertigo in Patients Affected With Familial Ménière’s Disease: A Clinical Comparison of Familial and Sporadic Ménière’s Disease.
Hietikko E, Sorri M, Männikkö M, Kotimäki J.
Am J Audiol. 2014 Jun 1;23(2):232-7. doi: 10.1044/2014_AJA-13-0060.
PMID: 24686733 [PubMed – in process]
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11. Mining immune epitopes in the inner ear.
Platt M, Dilwali S, Elackattu A, Parikh JR, Stankovic KM.
Otolaryngol Head Neck Surg. 2014 Mar;150(3):460-3. doi: 10.1177/0194599813514725. Epub 2013 Dec 23.
PMID: 24367049 [PubMed – indexed for MEDLINE]
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12. Corticosteroid therapy for hearing and balance disorders.
Trune DR, Canlon B.
Anat Rec (Hoboken). 2012 Nov;295(11):1928-43. doi: 10.1002/ar.22576. Epub 2012 Oct 8. Review.
PMID: 23044978 [PubMed – indexed for MEDLINE] Free PMC Article
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13. Meniere’s disease might be an autoimmune condition?
Greco A, Gallo A, Fusconi M, Marinelli C, Macri GF, de Vincentiis M.
Autoimmun Rev. 2012 Aug;11(10):731-8. doi: 10.1016/j.autrev.2012.01.004. Epub 2012 Jan 28. Review.
PMID: 22306860 [PubMed – indexed for MEDLINE] Free Article
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14. Ménière’s disease is a viral neuropathy.
Gacek RR.
ORL J Otorhinolaryngol Relat Spec. 2009;71(2):78-86. doi: 10.1159/000189783. Epub 2009 Jan 10.
PMID: 19142031 [PubMed – indexed for MEDLINE]
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15. The link between allergy and Menière’s disease.
Weinreich HM, Agrawal Y.
Curr Opin Otolaryngol Head Neck Surg. 2014 Jun;22(3):227-30. doi: 10.1097/MOO.0000000000000041.
PMID: 24573125 [PubMed – in process]
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16. Recent advances in viral inner ear disorders.
Beyea JA, Agrawal SK, Parnes LS.
Curr Opin Otolaryngol Head Neck Surg. 2012 Oct;20(5):404-8. doi: 10.1097/MOO.0b013e328357a6b3. Review.
PMID: 22902415 [PubMed – indexed for MEDLINE]
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4 Comments

  1. I’m 67, female. Finally seeing a functional medical practitioner, who have saved my life. My history include 6 cancers (uterine, melanoma, breast x2, lung and thyroid. Diabetic, peripheral neuropathy, chronic pancreatitis, shingles in ear x 3, celiac disease (just diagnosed, and we believe one of the underlying causes of much of my health issues, low blood pressure, heart attack, afib, pacemaker…..and the must goes on. I suffer from horrible balance issues, vertigo (not long lasting). I’m going to talk to my new FM doc about your article. FASCINATING AND THANK YOU!. Oh….need to let you know that I’m a survivor, very positive attitude and sense of humor. Was supposed to die more than once.

  2. First of all we are very glad that you have persevered through your health tribulations and applaud your proactive stance on taking care of your health with your FM practitioner. Relative to figuring out the cause of your imbalance and vertigo, we would need to do an examination on you to really identify what is going on. But what I will say is that imbalance is very common for neuropathy patients, and this is something we have seen consistent improvements in with our neuropathy patients. Please let us know if you and your FM practitioner have any questions and in any way that we can be of service to both of you.

  3. I am a 29 year old with vestibular neronitis, which came on after a virus last December. I am doing vestibular physio, retraining my balance. .I have visual disturbances but no hearing issues.

    you mention metabolic issues – in your experience, can a disfunctioning thyoid impact on vestibular neronitis?

    My dizziness is much worse if I am tired – why is that?

  4. Hello and thank you for your question.

    In our experience thyroid disorders can have an impact on vertigo and dizziness. The exact estimates vary, but most authors agree that a significant percentage of hypothyroid patients have a thyroid disorder due to the immune system killing the thyroid gland, and this is often referred to as Hashimoto’s thyroiditis. It is widely held that once there is one autoimmune process, it is much more probable that a second autoimmune process can occur. A direct relationship of hypothyroidism being associated with vestibular neuritis has not been discussed in the literature to my knowledge. However, there is some very interesting information coming out stating that about half of Hashimoto’s thyroiditis patients have vestibular damage (If you would like more information on this I attached the reference). This is brand new data and very exciting in our opinion.

    Additionally, as we discussed in the video, the key to improving from a vestibular disorder is to have a healthy cerebellum (for all intents and purposes the balance center of the brain). The intent of physiotherapy modalities for vestibular patients is to give activation to the cerebellum. As is discussed in the vestibular texts and literature, many with conditions like vestibular neuritis will improve with time and physiotherapy. Yet a certain percentage will not, and those are typically the cases we see in our clinic.

    There is now a lot of information coming out about how the immune cells (termed antibodies) involved with the thyroid can have cross reactivity to certain molecules in our food as well as all of these having cross reactivity to the cerebellum. Cross reactivity simply means that the immune cells will not only attack the food molecules as an example, but also the cerebellum, as though the cerebellum was a bacteria or a virus. If you would like to read more on this I recommend you google Dr. Hadjivassiliou. He is a neurologist out of the UK who has done the brunt of the work on immune related disorders to the cerebellum and cross reactivity of thyroid antibodies as well as antibodies that our common to our diet.

    So that is the long winded answer as to how vestibular neuritis could be associated with the thyroid. I can only conjecture that dizziness would increase in conjunction with the fatigue as possibly the fatigue and dizziness are secondary to the immune system being flared up to both areas of the body. Please feel free to discuss this information with your doctor. We are always trying to stay on top of the most recent literature for these subjects, and we would be happy to forward any references to you GP, neurologist or ENT. If you have any other questions we could go over them with a consultation.

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