As my temporal bone MRI date is approaching, I am thinking more and more about possible outcome and what conclusions could be made. The 3T MRI of the temporal bones should be able to identify if there is endolymphatic hydrops in one or both of my ears. An article about it was posted in this forum. I have somewhat atypical symptoms, no hearing loss, no fullness. Had 10 typical MM vertigo episodes (without hl and fullness) in five and a half years. Remissions were as long as 15 months and as short as eight days. My right vestibular sense was hypotonic (I think this means it was unusable), but recovered to 100% after a month. I am taking antivirals according to dr. Gacek's paper, atm it is 800 mg of acyclovir once a day. I also take Lemon Bioflavonoids (Nature's way brand), Vinpocetine and Gingko. I take 1000mg of Lysine as well. I plan to introduce the rest of JOH regimen gradually, after a colleague of mine comes back from the USA and bring those. Coming to my puzzle... If my symptoms are caused by a virus, should I expect to have or not have the endolymphatic hydrops? I know that there are people in this forum who did serious research and hope somebody would have a guess on this. Thanks in advance, and I want to thank you all nice people for all the information posted in this forum.
From Dr Hains site Recently, the most generally accepted idea that Meniere's disease and endolymphatic hydrops are always associated has been questioned. Hydrops is not found in all persons with Meniere's disease, and hydrops is also commonly found (6%) on autopsy studies of persons who had no Meniere's type symptoms (Honrubia, 1999; Rauch et al, 2001). Because Meniere's disease occurs in roughly 0.2/100 persons, and Hydrops is found in 6/100 temporal bones, there is more than an order of magnitude more people with hydrops than Meniere's disease. Thus logically, there must be something more than simply hydrops involved in the origin of Meniere's disease
Thank you Vicki. I am trying to be logical here. If antivirals help most people but not everybody, we could talk about Meniere's syndrome instead of Meniere's disease, as the term MM is used to address that "this is no known disease". It may be several still unknown diseases having similar presentation. One of them may be actually known (a neurotropic virus). So, my main concern is does virus-caused "MM" present endolymphatic hydrops. I mean, if only some of MM sufferers have the hydrops, and some of them react well to av therapy, is there some conclusion do MM sufferers who react well to av have the hydrops or not? Thanks
In my other thread I just posted a statement from a publication that says the reason why 90% of patients have vertigo control and 10% don't is because that 10% have a mutant form of the virus that does not respond to antivirals. I have no idea if having a virus attached to the nerve in the inner ear means one has hydrops or not.
I think a 3T MRI with appropriate contrast protocol should be able to show hydrops. Its not done much or correctly here in the USA i believe. I had an MRI that didnt show hydrops but it wasnt a 3T and they didnt give the contrast right IMO. Also, i have heard that hydrops can come and go and vary in intensity. The issue to me would seem to be looking at the endolymphatic sac and its role in regulating endolymph and whether the hydrops becomes chronic and severe. If the sac is functioning ok then maybe hydrops is eventually cleared before its creates symptoms. I believe I have/had hydrops and its the main reason for my symptoms. Maybe some remissions are when the sac is capable again of partial function and clears the endolymph enough to reduce symptoms. Since the sac is an immune organ too that seems to tie in all the immune stuff as a factor. Why hydrops sometimes effects balance and vertigo and not hearing Im not sure. Maybe its a structural issue that leads the hydrops to be worse in the utricle/saccule.
Thanks Gustav for your valuable input. My neurotologist told me that once you get the labyrinth hydrops it remains there, so it is acute condition. The reason why temporal bone MRI is not done routinely in the USA, I guess, is because of it cannot improve the therapy. Whether there is or is not a hydrops, the course of therapy does not change. I guess the insurance would not cover the cost too. The temporal bone MRI is not done routinely in Serbia too. I am lucky to have some personal connection, and the health system in my country is still not a kind of a money-making monster. Cheers