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Vertigo and Meniere's Disease/Syndrome

6/8/2013

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For the past 3+ weeks I have been dealing with a vertigo episode, or vertigo "attack" as I sometimes call it because it attacks my life and destroys it.

I should be grateful that it typically passes after about 3 weeks, but here I am into the fourth week and I still have to be careful about turning circles or getting out of bed too fast or I'll bring on the dizziness again.

What is vertigo? True vertigo involves the sensation that you are, or the world around you is, spinning. You experience that spinning whether you eyes are open or not, in a bright room or in pitch darkness. In fact, your eyes are darting back and forth as if you really were spinning and viewing the scenery going around you. But apparently the stimulus/response is reversed: the eye movement creates the illusion of spinning. 

I was lucky this time. I never went into the spinning. My eyeballs and head felt as if they were dangling at the end of  a Slinky. As the days wore on, the Slinky got shorter and less springy.  But I never had the bad spinning that causes severe nausea and vomiting. I attribute this small blessing to the fact that I have been on allergy shots again for several years. 

My vertigo episodes are triggered by allergies. I get the episodes when I stupidly go out and mow or weed or, in this case, all the above plus chainsaw down a dead juniper in my front yard...without a mask.  

The warning signs of an oncoming attack include: a feeling of heat, pressure and fullness in my ears (I feel as if I can hear my pulse throbbing sometimes),  ringing in the ears, and sometimes brief moments of lightheadedness. 

The inner ear specialist I saw during the previous episode 3 years ago had prescribed B vitamins, especially niacin (to improve blood flow to the brain), and low-dose Valium (to take when I feel the warning signs to abort the attack). I didn't like the hot flashes of the niacin and quit taking the B vitamins. The Valium may have helped abort attacks a couple of times over the past 3 years, but once this episode started the Valium only made me nauseated.

My usual pattern is that for one week I am completely useless. If I'm lucky, as I was this time, I can lie on the couch and watch TV if I keep my head still. But I sleep a lot. (If I'm not lucky, I spend that week taking phenergan suppositories to stop the vomiting and sleeping till it's time for another one.) Then for another 2 weeks I slowly become more functional. Still dizzy but half as dizzy each day. (Unless I do something stupid like trying to go back to my Zumba dance/workout class too soon.)  The second and third weeks are characterized by increasing functionality, but anything that requires visual focus or tracking is difficult and very tiring. And that eye strain can bring on or exacerbate the headache I already have from the pressure. 

(BTW, Botox injections in my brow and back of the head help prevent or minimize my headaches for about a year.)

Meniere's involves some of these symptoms, but in Meniere's, you lose hearing. Mine is fine. The conventional wisdom says that Meniere's is cause by fluid buildup somewhere inside the hearing apparatus. And the conventional treatments are things like B vitamins, low salt diet and diuretics to prevent or eliminate the buildup of excess fluid. If Meniere's persists, more barbaric treatments are used that destroy your hearing in order to stop the spinning and restore your balance. However, new research suggests there may be an earlier culprit in the sequence: neurotoxins. The theory is that these neurotoxins (which could be food additives like MSG that excite your brain cells to death, or in my case are probably the inhaled allergens) irritate the neurons in the brain and they become inflamed...and that inflammatory reaction is what causes the fluid buildup that causes the vertigo/dizziness.

In any case, my allergist has suggested something I haven't tried before: taking a course of prednisone when the warning signs first appear. I've taken it after the attack has started and it made no difference. But perhaps if I can reduce the inflammation, and potentially eliminate the fluid buildup, I can abort the attack.

The takeaway here is that if any of you suffer from these attacks, try the following:
1.  Figure out what triggers the attacks and stop doing it.
2.  Keep a bottle of ginger pills, a course of prednisone, some low-dose Valium (2mg), and some Antivert/meclizine in your medicine cabinet at all times, and some phenergan suppositories in the fridge.
3.  If you experience the warning signs, take either the Valium 3 times a day for up to 2 days or the prednisone course to abort the attack.
4.  If the attack starts, use the suppositories until you can keep something in your stomach, then start on the ginger and/or the Antivert until the nausea goes away.
5. Be prepared to just let it run its course. Don't try to do too much too soon, as much as you hate being out of action.

You may also try daily use of other botanicals that are said to help prevent vertigo, including ginkgo biloba and butchers broom (to increase blood flow to the brain). 

But here's hoping you never need any of this advice. 

- Pat
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    Author Pat O'Connell offers a variety of health-related articles for women and men. This information is for educational purposes only.
    NOTE: Please consult a medical professional before implementing these or any other health solutions. 

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