Meniere's Disease or Central Nervous System Disorder

[Gigi4647]

I was diagnoses with Meniere's Disease 8 years ago. I have levels of hearing loss in both ears. I recently saw an ENT Doctor who specializes specifically in diseases of the ears. He reviewed all old tests and disagreed with previous diagnosis. I was scheduled for many audiology tests. The results revealed I did not have Meniere's Disease. He told me I have a disease of the central nervous system and referred me back to my Neurologist for a final diagnosis. I was told my hearing loss is due to aging process and genetics. My episodes of dizziness are probably due to a nervous system disorder. My question is: How do audiology tests reveal diseases of the central nervous system?

[Nancy T]

I agree with lablarry that Meniere's disease should be considered in your case. If you are losing your hearing, you REALLY need to find a SPECIALIST in hearing and dizziness, ASAP--someone who is concerned to diagnose the cause of your problems and treat them aggressively.

If you haven't already, see a NEURO-OTOLOGIST (an ENT with extra training in the inner ear and its connections to the brain). It's also spelled neurotologist. You can find state-by-state lists at the Web sites of the American Neurotology Society and the Vestibular Disorders Association. Another type of specialist is an oto-neurologist, which is a neurologist with extra training in dizziness and the inner ear, though from the "brain side." Either type of specialist should be able to diagnose and treat you (though if surgery is needed, only neurotologists do this).

Migraine, by the way, can and often does cause dizziness problems. The relationship and overlap in symptoms between Meniere's disease, migraine-associated vertigo, and stroke or blood-flow problems is tangled. For interesting discussions and a place to ask questions of patients with a lot of experience and knowledge in these areas, join the Meniere's Discussion Group (MDG) at Yahoo Groups. Make sure it's the MDG, as I think there are several Meniere's groups at Yahoo. But, of course, your first and most important priority is to find a good ear/hearing specialist. You could also try calling your nearest university hospital and ask who their expert is, or who they would recommend in your area.

Fatigue, unsteadiness, and nausea are very common with inner-ear disorders, as are anxiety and problems with attention, concentration, memory, etc. They almost always go with the territory! The vestibular (balance) system is very closely tied to the sympathetic (?) nervous system (hope I got that right), which controls the fight-or-flight response, so anxiety is a common "side effect" of dizziness. And when your brain is using up a lot of its resources to try to deal with the bad input it's getting from a bad ear, and when your muscles are having to work harder to keep you steady and upright, that causes both mental and physical fatigue. If you get help for the underlying problem, those other symptoms should improve, too. Even if you cannot get a definitive diagnosis of the problem, various medications are available to help with all those awful other symptoms.

Just make sure your doctor understands exactly what your worst problems are and how they are affecting your life. Be persistent and insistent if necessary. Your hearing is very valuable, and usually doesn't come back once it's lost.

In re-reading your post, I see you were diagnosed with "CNS problems." What problems, and how did they diagnose them?

Best of luck!!

Nancy

[lablarry]

Sorry that in response to MJ6 not Nancy.

[lablarry]

Have you ruled out Meniere's Disease?  Ringing and vertigo sounds a lot like it.

[MJ6]

I too was diagnosed with CNS  problem due to my hearing loss in one ear (left), but I am losing my hearing in my right ear too.  I hear a motor like noise in my right ear and ringing in my left hear all the time.  It's driving me crazy.   My left ear has a ringing that goes with my heart beat.  I've been to a neurologist and ENT but things are getting worse.  I used to get vertigos and vomiting episodes but that are now gone, so it's my hearing that I am worried about.  I beginning to think that my problem might be bigger than my hearing or ears.  I feel tired and unsteady all the time.  I get dizzy and nausated when I look down or bend down.  I get migraine headaches and ocular migraine headaches in the left eye.  What do I need to do?  My ENT Doctor told me that I had chronic sinusitis and had surgery on my sinuses.  I don't know if my sinuses are still healing but I am losing my hearing in my right ear again.  Please help!

[Nancy T]

Part of the ENG (electronystagmography) testing--where you follow lights with your eyes) might show central nervous system problems in your eye movements.

Also, brainstem auditory evoked potentials (known as ABR, BAER, etc.) and I believe also acoustic reflex testing can show if there is disease affecting the hearing/balance nerve and/or brainstem.

However, it can sometimes be difficult even for neurologists or ENT ear specialists to say for sure whether symptoms are due to central or peripheral (ear) causes. Don't count for sure on getting a "final diagnosis." Lots of people go away from neurologists empty-handed as far as a diagnosis. Best of luck.