@KathyH - Pulsatile tinnitus can also be caused by internal jugular vein compression. I was given a medical research paper which discusses IJV compression in relation to Meniere's Disease (see link below). To get this checked out, you'd need to get a referral to an interventional radiologist & get a dynamic study of your IJVs & perhaps a venogram.
Here's the link for the John of Ohio regimen - JOH (John of Ohio) Regimen for Meniere's Disease details
IJV compression often doesn't show up when your head is in a neutral position which it is for the CTA/CTV (I just had those done as well). Since the IJV may not be compressed except when your head is in a particular position, the testing must be dynamic i.e. w/ your head in different positions i.e. looking up/down, left/right. This can be done via ultrasound or more invasively by angiogram/venogram.
thank you, the PA is asking the neurotologist about it... you have pulsatile, too? About 1/3 time the source is unknown.... My tinnitus evolved/devolved? over the 2 years to mostly pulsatile in right ear only, tinnitus high ring in both ears at times. I have SNHL in both ears.
Cortisone shots through my ear drum almost always made my symptoms worse for the first 2-3 days then helped relieve symptoms from a few days to a month or more. The most recent injections I had which were last fall didn't help at all. @KathyH - I hope the betahistine is helpful!
Addedum - after some thought, & w/ the new knowledge that EBV may be a contributor to MD, I am wondering if my cycling accident "reawakened" EBV in my body. The accident was in 2015 & in 2017, two years after the onset of my MD symptoms, a general blood test showed active EBV in my system. Since I am (or thought I was) asymptomatic, no treatment was offered. Now I'm wondering if I should get re-tested & look into anti-viral therapy.
I do not have pulsatile tinnitus though I wonder if I'd hear it if I did since I'm almost deaf in my left ear except for the constant tinnitus.
My 3 ear shots did not restore any hearing nor help the vertigo. Thank you, I hope the Betahistine helps too. My cousin's wife had a Vestibular Neurectomy in 2002 as she had vertigo for 5 days and was in the hospital to get it under control.... a total success, no more vertigo (but still tinnitus and hearing loss).
@KathyH - any news about the Betahistine? Were you able to get it, & if so, has it helped? I know it's early days yet if you started on it in April.
@Isaiah 40:31-I am taking Betahistine 16mg. 3Xday. No clue if anything helps. A problem as I see it is docs prescribe low sodium, no caffeine, no alcohol (the guilty pleasures) Betahistine diuretics all at once, the shotgun approach. SO, who knows which of these, if any, works? A theory is, to keep your system stable with no big changes in fluid retention. PLUS, attack any virus they may be in there. PLUS address any allergies that may trigger. I did read yesterday that the latest is MD is caused by virus.
My first symptom was probably 15 or so years ago. I had a crippling attack of vertigo and was laid up for a day. After it went away, I slept, then just felt like garbage for about a week. The doctor thought it was a side effect of a generic cholesterol drug I was taking. It recurred several times after that with no warning. Probably a couple times a year. Then stopped after a couple years. Then at my current job, I was answering the phone and found that I could barely hear what the person on the other end was saying. My first thought was, what was wrong with the phone. Then I switched ears and could hear perfectly. So I thought that was weird and called an ENT. That, coupled with my past vertigo attacks, made him diagnose me with Menieres. Since then, I've only had tinnitus and hearing loss. Then I decided to get intratympanic injections of dexamethasone last April. To see if it would help with my hearing. But those did nothing. I thought I was good with just the hearing loss + tinnitus. Until last July. I got hit with a tremendous vertigo attack. I hadn't felt that way in a LONG time. I really thought it was gone. I'd had mild dizzy spells. Some nausea now and then. But nothing like the vertigo where I'm completely unable to function. But here it was. AGAIN. Back after all these years. Of course, the ENT did nothing. I was already on a low-salt diet and a diuretic. Next was surgery, which I did NOT want. So I rediscovered the JOH regimen. I'd found it years ago, but since my symptoms disappeared, I never looked any further into it. This time, though, I went whole hog and started it in July. It got worse after a week or two. But then my last big attack was November. Which pretty much follows the prescribed timeline. I've been free of the vertigo attacks since then. (knocks on wood). I've supplemented it with some Inner Ear Balance which got my fluctuating tinnitus and ear fullness under control as well.
That's encouraging to those of us on the JOH regimen. Have you had your cervical spine alignment checked? A misalignment can throw you into sudden vertigo. It certainly has done this for me. I am starting on a low-histamine diet to try to control inflammation, because when my allergies flare up (like, now) the inflammation in my body seems to need some help by my eating low-histamine foods. That means cutting out my favorite foods--chocolate, yogurt, tomatoes, beans, citrus fruits, vinegar, fried foods. Most of us with MD seem to have seasonal allergies, so histamine intolerance may be a component of our problem.