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Meniere's Disease or MAV

Hey y’all!
I have a question regarding MAV. Can MAV mimic Meniere’s? I have had chronic 24/7 dizziness for about 5-6 years now. I have cognitive, memory, fatigue, reading problems, light sensitivity, feel shitty 24/7 and nauseous symptoms – and on and on. However, my neuro-otologist diagnosed me with Meniere’s (and migraine as well). I guess on the grounds that I have hearing loss in both ears. Both are high pitch losses I believe. My rotary chair test came back as that I have vestibular damage. And I have chronic ear pressure and aura. However, I don’t have vertigo at all. I have the 24/7 dizziness and off feeling. I feel like shit 24/7. I’ve tried about 14 different meds and nothing has helped with the dizziness. Can that all be symptoms of MAV? Or do you think a Meniere’s diagnosis is correct? I worry because I know Meniere’s is progressive – and I couldn’t imagine things getting even worse.

Thanks,
Stace

Hi,

Yes it does. Some people have had their vestibular nerve cut thinking it was Meniere’s when in fact it was vestibular migraine.

See the the following from Vestibular Migraine Diagnostic Criteria:

http://www.mvertigo.org/articles/lempert_vestibular_migraine2012.pdf

3.6. Overlap with Meniere’s disease

Migraine is more common in patients with Meniere’s disease than in healthy controls. Patients with features of both Meniere’s disease and vestibular migraine have been repeatedly reported. In fact, migraine and Meniere’s disease can be inherited as a symptom cluster. Fluctuating hearing loss, tinnitus and aural pressure may occur in vestibular migraine, but hearing loss does not progress to profound levels. Similarly, migraine headaches, photophobia and even migraine auras are common during Meniere attacks. The pathophysiological relationship between vestibular migraine and Meniere’s disease remains uncertain. In the first year after onset of symptoms, differentiation of vestibular migraine from Meniere’s disease may be challenging, as Meniere’s disease can be monosymptomatic with vestibular symptoms only in the early stages of the disease.

When the criteria for Meniere’s disease are met, particularly hearing loss as documented by audiometry, Meniere’s disease should be diagnosed, even if migraine symptoms occur during the vestibular attacks. Only patients who have two different types of attacks, one fulfilling the criteria for vestibular migraine and the other for Meniere’s disease, should be diagnosed with the two disorders. A future revision of this classification may include a vestibular migraine/Meniere’s disease overlap syndrome.

More on differential diagnosis here:

http://www.mvertigo.org/articles/vertigo_and_migraine2011.pdf

S 8)

if you have tried 14 meds and none even touched the dizziness, I wonder if it could be something non-vestibular as well? i mean maybe you do have mav or meniere’s but there could be something else going on to cause your ongoing problems?

Thanks so much for the info! I stopped going to the doctors because no one seemed to be able to help. But I’m going to see my neuro-otologist again on July 17th and I’m gonna ask him a lot of questions and try to be more aggressive on treatment as I all but gave up on ever feeling better. I’m gonna see if something else is going on as well as nothing seems to help. But I do honestly think a lot of it has to do with the extreme pressure I have in my ears all the time – it makes my head feel like it’s gonna burst. My nose feels pressurized too. I’m wondering if sinus problems and TMJ are worsening it everything?

Here’s the meds I’ve tried:

  • Diazide
  • Topamax
  • Nori
  • Citalopram
  • Prozac
  • Zoloft
  • Lexapro
  • Vivactil
  • Wellbutrin
  • Xanax
  • Klonopin
  • Lamictal
  • Neurontin

I might be missing some. Some have made me feel good at times, but none have touched the actual 24/7 off feeling/dizziness. Nori seemed to really help with the migraines. I’ve been struggling with migraines since I was about 13.

Hi Stace

I just wondered if you manage to live a relatively normal life given you have had this 5-6 years? Do you work? Have a family etc?

I believe there can be some overlap between MAV and Menieres so it can be hard to work out what is causing what. It does sound that as your symptoms are constant that MAV is more likely, as Menieres is meant to come in attacks of spinning and you said you don’t get any vertigo.

There are other meds to try I am sure. Are you in the USA? Have you tried beta blockers? Sodium Valproate? Flunarizine? Zonisamide? Sorry if you have, I am unsure of the all the US names for the drugs so you may have listed them already x