http://www.tampabayhearing.com/vestibularneuritis Very Interesting article about different causes of vertigo, it is fairly long so I wont paste it but the entire article has good information, but especially interesting is the section: Pathology of acute viral vestibular neuritis Postmortem studies of patients with well documented vestibular neuritis show evidence of injury to the ganglion cells in the vestibular nerve just proximal to the inner ear.[14], [15] Studies have also shown evidence that at least some of the time, Herpes Simplex is the putative cause. [16] Quite similar findings have been induced by herpes viral inoculation experimentally in small animals. [17] However, other literature suggests that adenovirus [18], enterovirus, Epstein Barr virus, and cytomegalovirus [19], as well as coxsackie and zoster viruses [20] can also cause vestibular neuritis. It is also clear that vestibular neuritis occurs in Ramsay Hunt syndrome implying that the Varicella Zoster virus (shingles virus) can cause vertigo.[F] Animal studies have demonstrated that several human viruses including rubeola, herpes simplex, reovirus, mouse and guinea pig cytomegalovirus, and neurotropic strains of influenza A and mumps virus, can infect the vestibular nerve and the vestibular membranous labyrinth. [21] Controversy remains about whether the presence of virus in the vestibular nerve implies cause of symptoms. Indeed, in random cadavers, over 40% of the time, either or both HSV or VZV can be found in the vestibular ganglia. [22] Studies of postmortem human temporal bones (by R Gacek) find vestibular nerve buds peripheral to Scarpa's ganglion with the notion that these are regenerative neurons that have not completely reached endorgan targets. [23] Regeneration of injured nerves is known to occur peripheral to involved ganglia and that regeneration can be quite disordered as is perhaps best exemplified in Bell's palsy. I.e., some degree of permanent vestibular impairment from neural injury is not unexpected and is in fact common in vestibular neuritis. It appears to be worse the more severely affected the caloric response abnormality found [7] and the ready inference is that a lesser but persisting degree of vestibular impairment exist in those with less obvious endorgan pathology. Limits exist below which finding vestibular imbalance may exist but tests are technically in the range of normal. I.e., the absence of callable abnormality on vestibular function tests does not rule abnormality out and that is quite consistent with the temporal bone vestibular nerve pathology Gacek reports. •[F] The author's experience is that 100% of vestibular neuritis patients have positive VZV titers but the pertinence of that finding is unknown. FYI: This balance center where the article is posted gets the same high percentage of success as Dr. Gacek does using antivirals to treat Meniere's.
On their webpage about Meniere's, is also an interesting article and this chart: Comparison of treatment options in Ménière’s disease http://www.tampabayhearing.com/menieresdisease Treatment Vertigo Control Medical management (low sodium diet, diuretic, antiviral, sedatives, anti-nausea) 70-80% Treatment does not cause hearing loss. No need to be off work Easy and inexpensive Takes 4 – 6 wks. to notice any effect Treatment Vertigo Control Meniett (if medical management fails) 70% Requires a tube in eardrum membrane, no change in hearing No need to be off work Office procedure, no real risk of hearing loss Expensive, $3500, not covered by insurance Treatment Vertigo Control Endolymphatic Sac Surgery (if medical management fails) 70% Treatment typically does not cause hearing loss 1-2 weeks off work on average Preserves residual hearing Outpatient surgery, 30% chance of no benefit Treatment Vertigo Control Middle Ear Gentamicin Perfusion (if medical management fails) 90%+ 10-20% chance of worse hearing if 2 or more injections are given. Off work 0-6 weeks off. Office procedure Hearing worse dose-related, imbalance improves with time Treatment Vertigo Control Vestibular Nerve Section (if medical management fails) 90% Worse hearing in 15-30%, some with better hearing 3 – 6 weeks needed off work Preserves residual hearing in most patients. Operation adjacent to brain requiring a short stay in ICU, imbalance improves with time Treatment Vertigo Control Labyrinthectomy (if medical management fails) 95% Complete loss of hearing in operated ear 2-6 weeks off work. Very good control of vertigo attacks Imbalance after procedure improves with time
I'm just so thankful I had my last vertigo attack in 2006,but I continue to have aural fullness.My balance problems could be due to osteoarthritis in my left knee.I've been getting cortisone shots in my left knee since January,2015.I had my right knee replaced 4 years ago.I use a cane that helps with the osteoarthritis and not necessarily with the Meniere's.