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VM Causation Debate !

Discovery in mice points to potential treatment for vestibular disorders

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This is huuuugeee >> regenerate hair cells in the inner ears of mice, allowing the animals to recover vestibular function.

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Amazing.

But let’s all not freak out about hair cells.

It’s not very scientific of me to say this but I don’t think MAVers are suffering from loss of hair (not in their ears in any case! :sweat_smile:): I believe it’s a systemic stability thing (hence why many struggle to compensate).

Whatever it is, many improve over a long period so it feels more benign to me.

Low frequency Hearing loss in EH is due to loss of hair cell.

Or is it? They now think it’s the Ganglion where that is happening (loss of Neurons)? I think the relevant paper is on here somewhere. I also suspect that that only occurs in Menieres due to extent of Reissner distension. Not saying hair cell loss isn’t an issue in other conditions.

But who knows. New science every day :slight_smile:

Dead person dissection shows hair cell loss due to Meniere’s (2017 paper)
A higher magnification of the cochlea showed outer hair cell loss in 72-year-old male patient diagnosed with Ménière’s disease

This is 100% not true. If this was the case every Meniere’s hearing loss would be reversible when the distension calms down.

This is the paper I was referring to, and maybe the reason why the hearing loss is not reversible for Menieres:

Note we know Menieres <> Hydrops, so we don’t know if mild to moderate Hydrops has the same problem.

My hunch is that cases of Hydrops far outnumber cases of Meniere’s. I reckon once imaging gets really good we’ll find it’s much MUCH more common.

The reason I mention distension is that at some point in Meniere’s the low frequency hairs hit the outer wall (The Reissner is has the weakest structure at low frequency, that’s why it moves more there). This doesn’t happen in mild/moderate hydrops because the distortion is not great enough and may help explain why there is no permanent hearing loss. The paper above argues that the over excitation of the hairs in this state causes a chemical fallout that causes apoptosis in the Ganglion. There was a video of the researchers work being presented, but for the life of me I cannot find it anymore. He’s a US medic, Dr. Cliff Megerian, I think. Great presenter.

Clearly loss of neurons in the Ganglion is a bit of a bummer, and therapy will be needed to either prevent that or somehow get them to grow again.

I dont agree. Medical community has one name for Idiopathic Endolymphatic hydrops which is Meniere’s . Anything that is not trauma driven is Idiopathic. Hence the popular paper which says Meniere’s and VM can have same Etiology.

Classic Menieres is more than that. It’s strange episodic vertigo out of nowhere. That is very different to continuous hydrops.

Idiopathic just means you don’t know who dunnit. I suspect a lot of trauma might be unidentified because causing a fistula is not likely to be painful.

There’s load of possibilities that idiopathic ear trouble is actually rooted in barotrauma during flights, diving incidents, over zealous use of q-tips, car crashes & whiplash, sports injury, the list goes on …

The biggest problem is the injuries might be so varied that you don’t know you’ve caused a perilymph leakage or some kind of concussion until months later when the hydrops shows up.

Just saying …

Not sure, Meniere’s is a chronic illness…refer the blog mind over Meniere’s

Sure it’s chronic, but starts out episodic and can disappear for months or years. This is totally different to other forms of hydrops.

I asked Dr.Hain about secondary hydrops. He looked at me and said secondary to what ?

I asked PLF causing hydrops and he said i have a PLF blog why create another disease out of the same ?

Hmmm …

PLF heals and leaves behind hydrops, simples. It is no longer PLF once it has healed, but leaves behind a fluid imbalance, possibly a complex 3D one.

There’s no point in calling it PLF once there’s no fistula anymore?

Sounds like a mix up of definitions.

he clearly said any PLF which leaks repeatedly needs surgery.

No doubt, but that’s moot.

Not moot, the endolympahtic sac can balance the fluid. you are wasting time waiting for a broken PLF to fix itself…if i had PLF and suffered for 3 years i would get surgery in a heart beat, sadly i don’t have PLF.

Glad you don’t need it. I believe Hain that 90% of people with PLF don’t need surgery.

I suspect the lingering hearing loss (despite vestibular stability) is down to the Hydrops, so things are not so quickly resolved afterwards. In fact my doctor alluded to the fact it takes many years (a decade from injury is not unreasonable). Of course this could also be related to middle ear inflammation that comes with it, so hard to separate all the impacts.

he clearly explained if the fluid imbalance from Meniere’s from a acute episode can fix itself in days why is the PLF different provided it healed completely ?

Yes, good point, and we do not know. Could it be the control system is upset, so it loses its calibration? What we do know is that people who’ve had PLF suffer longer term HF hearing loss. Some people are lucky and this resolves too with time, others, not so … I don’t know anyone who can explain that.

Not true, acute PLF patients had low frequency loss as well.