03:48am Thursday 21 November 2019

Could migraine be the missing link in the Meniérè’s mystery?

Thousands of innocent victims throughout the UK, (1 in 10 working age adults in the UK are affected by dizziness) and several suspects in the frame for the crime. The cause of Meniérè’s disease remains unknown; but is there a smoking gun to be found and if so, whose finger is on the trigger?

“Meniérè’s disease is characterised by several classic symptoms, including dizziness, vertigo, sickness, tinnitus and deafness,” explained Vivienne Michael, Chief Executive of Deafness Research UK. “Because of the unknown nature of the disease, Deafness Research UK has been using its innovative system of providing our scientists with a forum to discuss ideas in order to come up with a synthesis of the latest thinking to coincide with this year’s Meniérè’s Awareness Week from 9-15 October.”

Like any classic Marple mystery, the Deafness Research UK scientists have been faced with many characters, but the principal prime suspects are usually narrowed down to: head trauma, various viruses, auto-immune, hydrops and migraine. Deafness Research UK has interrogated them all and the final denouncement is ready. All have ‘form’ and ‘motive’, but who is guilty?

Head trauma can instantly be released as being innocent. While physical injury can indeed lead to Meniérè’s like symptoms, this would then be from a ‘known’ cause. Thus by definition, symptoms resulting from a known case cannot be Meniérè’s disease!

Viruses have been under the microscope for some time, including herpes (the cause of cold sores and shingles, etc.) and while it remains under suspicion, mainly due to anecdotal evidence coming out of the US, (some doctors have had success treating Meniérè’s symptoms by using antiviral drugs), much more research is needed. The auto immune system has also been cited as a potential culprit too and while allergic reaction is possible, it is again an area still needing a great deal of research, so the jury remains out.

The prime suspects are ‘hydrops’ and migraine and with good reason as they have left many clues at the scene of the crime. Meniérè’s is defined by some as idiopathic endolymphic hydrops (IEH) which in layman’s terms simply means an excessive build up of endolymphic fluid in the cochlea (inner ear) whose cause is unknown. However, recent research suggests hydrops may have been framed for a crime it did not commit. It now appears that not all patients suffering from Meniere’s symptoms have hydrops and hydrops has also been found in people who have never had the symptoms. The logic of this suggests that hydrops may not be the key pathology in Meniere’s and there must be something more than just hydrops involved in the origin of Meniere’s disease. It would seem we are back to square one, but are we?

The final suspect is migraine. On the face of it migraine is a different condition but shares many lines of symmetry with Meniérè’s. Both are characterised by dizziness, tinnitus, deafness and sickness but more notably, some of the treatments prescribed for migraine have been shown to be equally effective against Meniérè’s. This has led some to speculate that Meniérè’s and migraine are two faces of the same condition. With 50% of people with Meniérè’s sharing the symptoms of migraine, have we found our answer? If we are to finally pull the mask off Meniere’s disease will we find Migraine is revealed as the ultimate mastermind staring back at us?

“While many of these hypothesis are interesting, current thinking suggests that rather than having a single cause, Meniérè’s may be the ultimate way the cochlea responds to a wide variety of injuries,” added Vivienne. “Thus paradoxically, all the above suspects are perhaps guilty – and no one is. What is clear is that much more research is required to unmask the menace behind the Meniérè’s mystery once and for all.”

While there may not be a ‘lone gunman’ in the continuing saga of the Meniérè’s mystery, there is clearly more work for the scientific sleuths at Deafness Research UK.

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