By Brian Robinson.
The answer to this question pretty much depends on how you define ‘a cure’. If it means all symptoms disappear, your inner ear heals and your hearing returns to normal then the answer is no. If it means you no longer have disabling symptoms and your vertigo is eliminated or comes under control, then the answer I believe is yes.
I have had Meniere’s Disease for nearly ten years and until fairly recently my belief was that it could not be cured. General Practitioners in the UK do not appear to know much about this condition; they are not allowed to diagnose Meniere’s Disease; and therefore treatment options are limited. However, ear, nose and throat consultants are allowed to diagnose and can treat.
It is often said that Meniere’s is difficult to diagnose and this is certainly true in the early stages. There are after all many other conditions that can cause vertigo. However, in the latter stages, when certain boxes have been ticked, diagnosis should be pretty much routine. In Meniere’s, you would expect the sufferer to have vertigo; tinnitus; and there would be significant hearing loss especially in the lower frequencies. Now to the cure.
The first thing to say is that Meniere’s Disease always burns itself out which means everything settles down naturally. The problem with that, is it is difficult to predict when this will happen. It could fizzle out in four years: or it could take twenty years. My own view is that ten years seems to be the average. It is worth mentioning that Meniere’s does go through stages and so it is possible to track the condition to some degree. And also, when hearing loss is severe or profound this could be seen as a sign that the condition is nearing burn-out. It is also worth saying that the experts do not seem to know exactly what happens in the inner ear when burn-out occurs. I have a suspicion that the brain may also be involved in the sense that it eventually becomes de-sensitised to the confusing signals being sent from the damaged ear.
In 80% of sufferers medication can control vertigo and by control I mean that the vertigo is pretty much eliminated. GPs can only prescribe Betahistine up to 16mg, but consultants can increase that considerably and may also prescribe a diuretic. Both these medications are designed to settle things in the inner ear and both are known to be effective. But bear in mind, however, that the inner ear will still be damaged and this may cause some dizziness and balance problems to persist. The brain will try and compensate for this so we should be optimistic that this too may settle in time.
In 15% of sufferers steroid injections directly into the ear will eliminate vertigo. Some UK consultants use one injection but some in the USA treat with four injections. This is not a painful procedure but it can cause some discomfort. The eardrum is first numbed with a cream so the injection itself is pain free, but you may feel some pressure as the liquid floods and fills the ear. The experts do not appear to know exactly what these injections accomplish apart from their obvious anti-inflammatory effect. However, steroids and steroid injections are used widely in the body to treat all sorts of conditions.
Personally, I would not be happy with just one injection as I believe these have a cumulative effect and therefore four is better than one. There is no downside to multiple injections apart from the discomfort. It may also take a little time for things to settle after the injections. You would need to give it at least a month or perhaps two to see the full benefit. Also, there is no reason why the injections cannot be repeated if say they give you a year free of vertigo.
In the final 5% of sufferers an operation may become necessary. Several operations are available which I do not intend to cover here. You may have to jump through one or two hoops before considering the operation which does guarantee a fix. This would involve a brain operation where the balance nerve which runs from the inner ear to the brain is severed. Once that is cut the vertigo stops and the sufferer is essentially free from the disabling symptoms.
You may have already gathered that I am writing this as a sufferer rather than an expert. However, I was lucky enough to find a top London/Harley Street consultant who was able to diagnose and treat my condition. All the above information has been gleaned from my consultations with him or my direct experience.
In my case, increasing the medication was not an option because of my age. I therefore had a steroid injection each week for four weeks. During this treatment I experienced fairly mild dizziness and for about three weeks afterwards. Then the dizziness stopped. Since then I have been vertigo free and feeling much better. If I should relapse I will of course update this post.