MenieresInfo.com Blog

A reader asks:

For a couple of years, I have had all of the symptoms of Meniere’s Disease, plus fever on the left side of the head but focused on the ear. When I recently moved to a city at a higher elevation, my symptoms were more pronounced during the drive. Has there been any research on the effect of atmospheric pressure on the symptoms of Meniere’s Disease?

Virtually all published research can be found at PubMed. You can search PubMed for connections between Meniere’s Disease and atmospheric pressure by clicking here. Virtually all current clinical trials can be found here. Forms of research not falling into these two categories can be difficult to find.

What you describe is a decrease in atmospheric pressure. Anecdotally, some patients have reported that increases in barometric pressure, as from an approaching storm, can trigger or exacerbate their symptoms. Avoiding one’s triggers, or at least, observing one’s triggers, can be an important part of treatment. See the MeniereInfo.com Treatment Page. Also anecdotally, most patients seem able to fly without problems due to pressure changes, and we don’t recall any anecdotal reports that patients have worsened or bettered their symptoms in the long term by simply moving to different elevations. One of the treatments for Meniere’s Disease is the Meniett Device, which introduces pulses of pressure into the middle ear.

All that said, it seems to us that atmospheric pressure, like almost everything else, affects us all differently, and that there have been no certain conclusions reached.

We don’t know what you mean by “fever on the left side of the head but focused on the ear,” but whatever it means, it is not one of the four classic symptoms of Meniere’s Disease. See the MenieresInfo.com Symptoms Page.

We recommend that you proceed with all possible haste to medical professionals for the purpose of finding out what is causing your symptoms and getting treatment. There are resources to help you to find a doctor at the MenieresInfo.com Doctors Page. The symptoms of Meniere’s Disease are also the symptoms of many other disorders. It takes medical professionals and a differential diagnosis to determine what might be the cause of the symptoms that are shared by Meniere’s Disease and other disorders. See the MenieresInfo.com Diagnosis Page.

A reader asks:

I have been taking anti-depressant drugs for over a decade, including zoloft, welbutrin, seroquil, and effexor. More recently, I received inoculations for hepatitis a and b prior to international travel. Just a few weeks ago, I developed symptoms consistent with Meniere’s Disease. Could the anti-depressants, or the hepatitis inoculations, have caused Meniere’s Disease?

Meniere’s Disease is “idiopathic,” meaning that the cause is unknown. Therefore, the question “can this cause Meniere’s Disease,” is always answered “no,” or, at least “as far as is known, no.” See the MenieresInfo.com Cause Page.

Many, perhaps most, people who have Meniere’s Disease have not taken anti-depressant drugs or received hepatitis inoculations prior to developing symptoms. (It is not unusual to develop depression in conjunction with Meniere’s Disease and thereafter begin taking anti-depressant drugs.) Surely many people have taken anti-depressant drugs long term and or have received hepatitis inoculations without developing Meniere’s Disease.

But this means nothing one way or the other as to whether you have Meniere’s Disease. Remember that the symptoms of Meniere’s Disease are also the symptoms of many other disorders. Only a differential diagnosis by medical professionals can determine which of the many possibilities is responsible for your symptoms. See the MenieresInfo.com Diagnosis Page.

A reader asks:

I have had rotational vertigo going on two months now and still getting worse. The second doctor that I have gone to thinks that I might have Meniere’s Disease. I have gone through the inner ear tests with no abnormalities and have a CAT scan and MRI scheduled. This doctor has recommended meclizine hydrochloride (Bonine and some other over-the-counter brands) and this greatly helps my nausea, but does nothing for my vertigo. My hearing is perfect, I have no tinnitus, and I have no aural fullness. I see that Menieres is progressive, but can it start with only one of the four “classic” symptoms?

This reader has one symptom: persistent, progressive, rotational vertigo. Although there are many definitions of Meniere’s Disease, the most commonly-used definition of “classic” Meniere’s Disease may be found here, which, generally, contemplates four fluctuating symptoms: rotational vertigo, hearing loss, aural fullness, and tinnitus. One of the reader’s doctors has remarked that the reader “might” have Meniere’s Disease.

We speculate that the reader (1) is desperately looking for a diagnosis, even Meniere’s Disease, and (2) is worried that it might be Meniere’s Disease.

As always, we recommend that our reader take one’s concerns to one’s doctor and discuss them. Often a patient’s concerns arise upon reflection and research after one has left the doctor’s office, and one needs to return to the doctor to discuss one’s concerns. We always recommend multiple medical opinions, both for diagnosis and for treatment options. This reader has seen two doctors so far. Seeing more doctors would not, in our opinion, be unreasonable.

The doctor’s remark that the reader “might” have Meniere’s Disease needs to be evaluated in its full context, to which we are not privy. Sometimes a doctor, faced with an uncertain diagnosis involving rotational vertigo, might say “might” with respect to Meniere’s Disease, since Meniere’s Disease for some doctors is the default diagnostic possibility when a more obvious or conclusive diagnosis is not handy. Sometimes a doctor will just make an offhand remark without intending the serious ramifications that a patient might well attach to the remark. In any event, a definitive diagnosis of Meniere’s Disease can only be accomplished by ruling out all other possible disorders having the same or similar symptoms — of which there are many. See the MenieresInfo.com Diagnosis Page, and the section on mimics.

There is no “typical” way that Meniere’s Disease begins. Each patient has one’s own story to tell. See our previous answer to a similar question here. For some of us with Meniere’s Disease, an initial acute attack is marked by all the symptoms. Others of us experience one or two symptoms first, and the other symptoms later. There is just no “typical” pattern, or at least no typical pattern that we have discerned or read about.

Vertigo alone, and vertigo in conjunction with the other symptoms of Meniere’s Disease and a whole lot of other disorders, can be difficult to diagnose. One must be patient while doctors go through the process of differential diagnosis to confirm or eliminate possibilities. With the one symptom of vertigo, there are many, many, many possible disorders about which to worry — Meniere’s Disease being just one of them. We suggest not worrying about any one possibility and instead focusing on getting the diagnostic tests that may help to further the differential diagnosis. (Once again, see the MenieresInfo.com Diagnosis Page.)

It is interesting that our reader is scheduled for both a CT scan and an MRI scan. Perhaps it would be too presumptuous of us to think that both scans are targeted toward the reader’s head. The usual (but not exclusive) choice would be an MRI scan, for the purpose of looking for, among other possible abnormalities, acoustic neuroma (benign tumor on the 8th cranial nerve), or plaque on the brain (which might suggest Multiple Sclerosis).

It is also interesting that our reader reports that meclizine hydrochloride helps one’s nausea but not one’s vertigo. It has yet to be determined that this reader actually has Meniere’s Disease. However, we should note that nausea is not a symptom of Meniere’s Disease. Nausea can often be a consequence of the Meniere’s Disease symptom of vertigo. Without vertigo, Meniere’s Disease patients are not expected to experience nausea. Meclizine hydrochloride is intended to treat vertigo by sedating the vestibular system rather than treat the secondary symptom of nausea, which in Meniere’s Disease patients is often treated with phenergan or compazine. However, meclizine hydrochloride does have antiemetic properties. See Dr. Hain’s information here and here.

A reader asks:

I experienced extreme pressure and tinnitus in both ears during a recent cold. I had a fluid buildup in my ears and my Eustachian tubes were blocked. I was a bit dizzy but did not experience rotational vertigo. After several weeks, the Eustachian tubes unblocked and the fluid in my ears was gone. I continue to have slight dizziness that comes and goes, and fullness and tinnitus in both ears. The tinnitus is intense enough to make it hard to sleep. I saw an otolaryngologist today. A hearing test showed no hearing loss. The doctor said I may have Meniere’s Disease, and prescribed a steroid, a diuretic, and a low sodium diet. If it is Meniere’s Disease, then I know that it was caused by the cold. I read up on Meniere’s Disease and it looks pretty scary. I’m hoping that the steroid, diuretic, and low sodium diet will clear this up and that it is not Meniere’s Disease. I have no hearing loss and no vertigo (just the slight dizziness), so could this really be Meniere’s Disease? Could this be early stages of Meniere’s Disease that will get much worse?

Our response to the question “Do I or could I have Meniere’s Disease?” is always the same: we don’t know. Only a medical professional who has conducted the necessary tests and taken the necessary history can diagnose Meniere’s Disease. See the MenieresInfo.com Diagnosis Page.

Our reader seems pretty sure that one is not experiencing rotational vertigo, but, rather, some other form of dizziness such as faintness, loss of balance, weakness, or light-headedness. Still, sorting out the term “dizziness” can be challenging, and it may take diagnostic tests by medical professionals to be definitive.

“Classic” Meniere’s Disease has four fluctuating symptoms: rotational vertigo, aural fullness, hearing loss, and tinnitus. “Atypical” Meniere’s Disease has fluctuating symptoms of both aural fullness and tinnitus, plus the fluctuating symptom of either hearing loss OR rotational vertigo. See the MenieresInfo.com Symptoms Page.

Meniere’s Disease is “idiopathic,” which means “cause unknown.” If you have Meniere’s Disease, you do not know the cause. So far, nothing, including colds and annoying in-laws, is known to be a cause of Meniere’s Disease. See the MenieresInfo.com Cause Page.

Diagnosis of the symptoms of Meniere’s Disease is difficult, because there are many disorders (”mimics”) that have the same symptoms. See the MenieresInfo.com section on mimics.

The only diagnostic test that you describe is a hearing test. It takes quite a bit more testing to establish whether one has Meniere’s Disease. Once again, see the MenieresInfo.com Diagnosis Page.

Meniere’s Disease is progressive. See the MenieresInfo.com Prognosis Page.

If you become deprived of sleep due to tinnitus, you should contact your doctor and discuss prescription options that may help you to get some sleep. This is very important.

We, who are not doctors, cannot tell you one way or the other whether you have, or might have, Meniere’s Disease. Only a medical professional can do that. There are many disorders that can produce the symptoms of Meniere’s Disease. It takes a differential diagnosis and diagnostic testing to sort out such symptoms. We always recommend multiple medical opinions, both for diagnosis and for treatment options.

A reader asks:

How does Meniere’s Disease begin most commonly?

We don’t know. But it seems that there is little that is “normal” or “common” in dealing with Meniere’s Disease. Of all the many anecdotes about the onset of Meniere’s Disease, we, at least, have not seen anything in the way of consistency. We haven’t seen any study that answers the question.

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