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Severe dizziness treated with steroid injections into the eardrum

April 12th, 2017

Kate Wighton, Communications and Public Affairs, Imperial College London

Injections of steroid into the ear are an effective treatment for a common form of sever dizziness, suggests a new study.

In a new trial, scientists from Imperial College London compared current treatments for Meniere’s disease, which causes debilitating dizzy spells.

They found that injections of the steroid methylprednisolone, through the ear drum, are as effective as the current ‘gold standard’ treatment. The current option is an antibiotic called gentamicin, and is also injected into the ear, where it destroys inner ear cells. The treatment prevents dizziness attacks, but can leave patients with permanent hearing damage.

The new trial, published in the Lancet, found that the steroid injections are as effective as gentamicin, but without the side effects. Patients who received the steroid injections were better at hearing speech clearly, compared to those who received the gentamicin injections.

injections pic

The researchers are now recommending medics offer the steroid injections to patients before trying gentamicin.

Professor Adolfo Bronstein, lead author on the paper from the Department of Medicine at Imperial, said: “Meniere’s disease causes disabling attacks of dizziness that in some cases can leave people unable to work. However at the moment the only treatment we have for severe cases is a so-called ‘destructive treatment’ that kill cells in the inner ear. Doctors, including ourselves, always assumed steroid injections were less effective than the current treatment, but we were surprised to see they work just as well as gentamicin, but do much less harm.”

Meniere’s disease affects around 30,000 people in the UK, and causes intense attacks of dizziness that last anything from a few minutes to 24 hours. During the attacks a person is usually unable to stand, and suffers from hearing loss, as well as nausea or even vomiting. The condition usually strikes people over 40, though scientists still do not know what triggers the disease. One theory is that the condition causes a build-up of salt and fluid in the inner ear.

This section of the ear, which is closest to the brain, holds equipment crucial to maintaining balance. This equipment constantly communicates with the brain, eyes and limbs to keep us on our feet.

Scientists believe the build-up of pressure can cause tiny leaks of fluid in the inner ear, which can cause the balance equipment to malfunction. The condition can also lead to permanent hearing loss.

There is no cure, although the early stages of the disease can be treated with medication and exercises. Severe cases can be treated with injections of gentamicin. After being injected into the ear, the medicine travels to the inner ear where it destroys the cells responsible for balance, and stops the dizzy spells. Usually only one ear is affected, therefore patients still have a working balance mechanism in their healthy ear, and can re-train their balance with exercises.

However, gentamicin can also destroy hearing cells, and up to one in five patients can be left with permanent hearing loss.

Benefits for patients

In the latest study, researchers at Imperial gave 60 patients with severe Meniere’s disease either injections of gentamicin or steroids. The patients were on average having more than one dizziness attack a week. They were given two injections of one of the treatments, under local anaesthetic, two weeks apart. Neither the patient nor the researcher knew whether a patient received steroid or the gentamicin.

After a two year period, all patients’ dizziness attacks had reduced by around 90 per cent. However the patients who received the steroid injections had better speech discrimination – the ability to hear words clearly – than those who received gentamicin.

Neither treatments were found to have any other side effects, although the injections of gentamicin often triggered a severe dizziness attack when first administered.

Professor Bronstein added that those who received steroid injections were more likely to need additional jabs to stop their dizzy spells.

“For a patient who lives in a remote location where accessing repeat injections would be difficult, then gentamicin would be an option. However, if a patient is able to receive repeat injections, and is concerned about future hearing loss, the steroid injections may be a better choice.”

Natasha Harrington-Benton, Director of the Meniere’s Society, who funded the research said: “We are pleased to have been able to support this research and are encouraged by the outcome. The trial has led to a better understanding of gentamicin and steroid treatments for Meniere’s disease; giving hope to those affected by this complex condition.”

The research was funded by the Meniere’s Society

“Intratympanic methylprednisolone versus gentamicin in patients with unilateral Ménière’s disease: a randomised, double-blind, comparative effectiveness trial” by M.Patel at al is published in The Lancet.  http://thelancet.com/journals/lancet/article/PIIS0140-6736(16)31461-1/fulltext

This article was first published on 16 November 2016 on the Imperial College website and is reproduced with permission. View the original article here http://www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssummary/news_16-11-2016-17-45-52

 

Editor’s Note:

Another steroid, Dexamethasone, has also been shown to be very effective in clinical trials in treating Meniere’s disease.

More than feeling ‘a bit rocky’. Mal de Debarquement Syndrome (MdDS) Australia quality of life survey

April 12th, 2017

This report is the first study to investigate quality of life for those suffering with Mal de Debarquement Syndrome (MdDS). In June 2016, members of MdDS Australia were invited to participate in an anonymous online survey investigating their quality of life in regards to general health status; work and social activities; depression and fatigue; life enjoyment; and MdDS inference in daily activities.

Sixty-three members (73% response rate) completed the survey over the four-week period. Average age of the respondents was 41 years, with 96% of the respondents being female. Time of onset to official MdDS diagnosis was 2 years. The general health of respondents was fair to good but there was noticeable response regarding the future of their health status in the future. MdDS has a notable effect on activities of daily living, and also the work environment (including housework), where many respondents noted that they have modified their working hours/load to accommodate MdDS. There was almost unanimous agreement that there is significant ignorance or misunderstanding of MdDS by clinicians and allied health workers. Also, the lack of understanding of MdDS in the wider community may also play an effect on the working environment for respondents.

Overall, this preliminary survey has found that the multiple variables of ignorance/misunderstanding, modification of the working environment (including housework), and being unsure of the future, collectively contribute to constant anxiety and worry about MdDS which is likely to have an affect on cognitive abilities and the mental health of a majority of respondents. Future research should look at creating an individual quality of life score to understand how MdDS affects each person specifically.

Click here to read the full report.

Emeritus Professor William Gibson AO – Biography Launch

March 6th, 2017

Bill Gibson_approved cover copy

Most people in hearing impaired circles in Australia would have heard of the renowned ear, nose and throat (ENT) surgeon, Emeritus Professor Bill Gibson AO. He is a world expert in both Meniere’s disease and cochlear implantation. There are more than forty patient stories in his biography. While most are about cochlear implant recipients, of different ages and backgrounds, two of the stories are about sufferers of Meniere’s disease.

Between 1984 and 2014, Bill Gibson performed the bionic ear operation more than 2000 times, making him one of the most prolific surgeons in his field. During that time he was a patron, friend and/or expert for many hearing associations including the Whirled Foundation, for which he is a life member and has contributed articles for the newsletter Equilibrium.

The foreword to the biography, supplied by Professor The Honourable Dame Marie Bashir AD CVO, concludes with the following quote: ‘Professor Bill Gibson is an outstanding man, a great humanitarian and deserving of this well-researched biography about his exceptional contribution to medicine’.

Bill Gibson: pioneering bionic ear surgeon, by Tina K Allen (NewSouth Press, 1 March 2017) includes an eight-page photo section with thirty-two illustrations. A book order form can be downloaded from the CICADA website by clicking here  ($25 + P&H) and copies of the paperback and e-book are also available to purchase from on-line booksellers or from your local bookshop (RRP $35).

More Awareness Needed

March 6th, 2017

“I suffer from vertigo and it’s bloody awful. Last year I suffered from sudden hearing loss just overnight. It threw my balance out for 6 months. I couldnt stand for long, everything was spinning. It has improved now but I still get bouts of vertigo, its very scary. Doctor and specialist dont know why this happened. I took stemetil tablets for 6 months for the severe vertigo. Then gradually I was able to stand and walk by myself without any medication. It has left me being scared to the point where someone in my family goes shopping with me. It changes your life big time. More awareness is needed.”

Have you ever tried to explain your vertigo symptoms to someone and had the response “Oh yeah, I get dizzy too sometimes” ?

You’re not alone! If there is anything our members wish for more, other than a cure, it’s more understanding from family, friends and colleagues.

“I experienced vertigo for 48 hours. I’m not sure what caused it but it was the worst feeling, it made me terribly sick, I wouldn’t wish it on anyone. I was lucky because it stopped after 48 hours and I haven’t experienced it since. But unfortunately some people suffer all day everyday. You really don’t know what it is like until you experience it yourself.”

One of the aims of Whirled Foundation is to raise community awareness of vestibular disorders and the impact they have on those living with the symptoms day to day. You too can help us spread the word.

Click here to download our poster, print and pin up at your place of work, local GP waiting rooms, local library or community centre.

Purchase our awareness wristbands. Click here to place an order.

For more ideas on how you can help us raise awareness click here.

Mal de Debarquement Syndrome (MdDS) Research

March 6th, 2017

Mal de Debarquement Syndrome (MdDS) is a rare neurological condition that affects the vestibular system, which controls balance. The condition is experienced more by women and has no cure.

Symptoms of MdDS include a continuous swaying, rocking, or motion-like feeling that typically arises following a motion experience such as traveling on sea. It can also have a spontaneous onset, where patients cannot attribute the onset of their symptoms to a motion-event. It is estimated to affect 12,000 people in Australia, and 3 million worldwide. As the discovery and research of MdDS is still novel, the underlying cause and aetiology of symptoms is currently unknown, and thus treatments for this condition have yet to be completely effective.

Dr Cherylea Browne from the MdDS Research Group at Western Sydney University became interested in MdDS after her own diagnosis of the condition and is now conducting research into the clinical features of MdDS. Her interests include the underlying hormonal aspects of MdDS and autonomic nervous system maladaptation in MdDS patients. The MdDS Research Group, though early in its formation, has generated interest from around the world, with collaborators contributing to research studies from Mt Sinai Hospital in New York, Prince of Wales Hospital in Sydney and Antwerp University Hospital in Belgium.

Currently, the research group has a questionnaire available for people with MdDS whose initial onset was due to a motion event. Click on the following link to participate in the research. This questionnaire will be open until the 15th of March 2017:

https://www.surveymonkey.com/r/MdDS_Survey_Browne

Other questionnaires and other research projects that require participants to visit the laboratory in Sydney will be advertised on the MdDS Research Group Facebook page:  https://www.facebook.com/MdDSResearchGroup/

Please contact Dr Cherylea Browne c.browne@westernsydney.edu.au  for any information regarding research projects, collaborations or research student opportunities.

Meniere’s Disease and Hearing Disorders

March 6th, 2017

Hearing impairment is underestimated and costly, but a new inquiry is set to amplify attention on the problem.

At 15, schoolgirl Elizabeth Bova, worn down by violent dizzy attacks and ringing ears, asked her neurologist to destroy a critical part of her inner ear in the hope of regaining some semblance of peace.

Since her first year in high school, the Sydney teen had been struggling with Ménière’s disease, an incurable condition that disturbs the hearing and balance regulators.

“I was at a terrible low after a run of random dizzy and vomiting attacks, and the ringing in my ears was driving me insane because you can never switch it off,” says the now 27-year-old allied health worker.

“I was so fed up I asked my doctor for the injection that kills off your vestibular, but of course he refused because he knew it would have left me completely deaf in one ear.”

Bova, who contracted the disease at 12, is now among the estimated one in six Australians who suffers from a hearing/balance disorder, a statistic that has prompted the federal government to open a national inquiry into hearing health and wellbeing.

The standing committee on health, aged care and sport began sittings in November last year with further hearings scheduled to run until about June in centres across the country.

Continue reading the full article:
https://www.thesaturdaypaper.com.au/…/menier…/14885460004282

Inquiry into the Hearing Health and Wellbeing of Australia

January 31st, 2017

Following a referral on 2 November 2016 from the then Minister for Health, Aged Care and Sport, The Hon Sussan Ley MP, the Parliament of Australia announced an inquiry into the Hearing Health and Wellbeing of Australia. Interested persons and organisations were invited to make submissions addressing the following terms of reference:

Taking into consideration the significant percentage of Australians experiencing hearing loss and the related social and economic impact of hearing impairment to the long term health and wellbeing of Australia, the Standing Committee on Health, Aged Care and Sport will inquire into and report on:

  1. The current causes and costs of hearing loss, and ear or balance disorder to the Australian health care system should existing arrangements remain in place;
  2. Community awareness, information, education and promotion about hearing loss and health care;
  3. Access to, and cost of services, which include hearing assessments, treatment and support, Auslan language services, and new hearing aid technology;
  4. Current access, support and cost of hearing health care for vulnerable populations, including: culturally and linguistically diverse people, the elderly, Aboriginal and Torres Strait Islanders and people living in rural and regional areas;
  5. Current demand and future need for hearing checks and screening, especially for children (12 years and younger) and older Australians at key life stages
  6. Access, availability and cost of required drugs, treatments and support for chronic ear and balance disorders sufferers;
  7. Best practice and proposed innovative models of hearing health care to improve access, quality and affordability;
  8. Developments in research into hearing loss, including: prevention, causes, treatment regimes, and potential new technologies;
  9. Whether hearing health and wellbeing should be considered as the next National Health Priority for Australia; and
  10. Any other relevant matter.

Whirled Foundation made a submission on behalf of all Australians living with balance disorders. Click here to read the submission.

Whirled Foundation Seeking Volunteers

December 16th, 2016

Whirled Foundation is seeking Volunteers for the following roles:

Non Executive Board DirectorClick here for more information

  • Marketing SpecialistClick here for more information
  • Journalist – Health IssuesClick here for more information

If you are interested in any of these positions please email Harry – harry@whirledfoundation.org

Break the Sound Barrier – Making hearing a national health priority

December 7th, 2016

Earlier this year Whirled Foundation partnered in the Deafness Forum of Australia’s “Break the Sound Barrier” campaign to make hearing health one of Australia’s national health priorities.

1 in 6 Australians are affected by hearing loss, are deaf or live with an ear or balance disorder. That’s nearly 4 Million Aussies.

The campaign is uniting people who are Deaf or have hearing loss or ear/balance disorders, service providers and health professionals to demand we be heard.

Deafness Forum of Australia Chair David Brady says becoming a national health priority will unlock more funding for much needed services.  These include free hearing checks in our schools, more investment in research to find better treatments, and improved community education so people understand hearing health issues better. It would also address an issue that costs Australia at least $11 Billion a year in avoidable health costs and lost productivity.

Following a referral on 2 November 2016 from the Minister for Health, Aged Care and Sport, The Hon Sussan Ley MP, the Parliament of Australia announced an inquiry into the Hearing Health and Wellbeing of Australia. Interested persons and organisations are invited to make submissions addressing the terms of reference by December 23. Whirled Foundation will be writing a submission on behalf of all Australians living with balance disorders.

Have you ever wanted to tell people what it feels like to have a dizziness and imbalance attack? Want to let Politicians know what they should do to help you and other sufferers? Well this is your chance!

The enquiry is asking how access to assessment, treatment, education and information could be improved. What drugs, treatments and support are required and at what cost to the patient etc.

Why don’t you tell them what you think, and what would make life easier for you.

Whirled Foundation encourages you to have your say and make a submission. If you do, please send us copy.

Details and Terms of Reference of the House of Representatives Standing Committee on Health, Aged Care and Sport Inquiry into the Hearing Health and Wellbeing Of Australia and how to make a Submission can be found by clicking here.

You can still show your support and tell our national and state leaders that Hearing Health and Well Being must be and should be a National Health Priority by signing up to the Break the Sound Barrier Campaign – if you have not done please sign up at http://breakthesoundbarrier.org.au/ Please share with your families, friends, communities, and work colleagues…..as the more we have signed up….the more we can make it REAL.

5 Ways to Improve Your Balance & Clarity

December 7th, 2016

1. Sleep more. Not less.  Your brain may need more sleep than usual, especially if you have a vestibular injury, migraine or anxiety condition.  Learn strategies that reduce your reliance on sleeping medications.  Experiment with different tricks, find ones that work for you.  Learning sleep skills is a large part of vestibular rehabilitation.

2. Stay supported. Get the social and emotional support you need to feel at ease.  Worries and chronic stress delay our neural recovery (the science is out on this one).  The brain needs to “feel at ease” in order to build new balance pathways.   Stress is a natural part of the dizzy process… make sure you learn HOW to bounce back and feel truly supported. We will all experience stress.  Learn how to ease into it.  There are oodles of strategies.

3. Drink water, stay hydrated.  Our senses need water to operate.  Without hydration, we can feel foggy, fuzzy and drained.  Drink before you feel thirsty.  Drink often.  This is nice and simple.

4. Commit to your recovery daily. Do your balance exercises.  Stay supported. Make sure your balance exercises are unique to you and your condition.  Take note of your progress, no matter how small.  Engage in the neuroplasticity process.  Have an action plan and someone to share the journey with.  Be accountable. On that note: Don’t over-medicate.  Make sure your specialists are in communication with each other. Drug interactions can impact on our ability to think clearly.  Be informed.  Aim to reduce medications if it is safe to do so, as you develop new balance pathways or “filter settings” in your balance brain.

5. Seek activities that fill you with joy.  Do those activities.  Do them often.  Daily. Offer yourself kindness when you feel tender.  Keep going and keep doing things that make you feel like the person you want to be.  This keeps you active, builds new balance pathways and injects you with vigour.

Sourced from Seeking Balance Australia for Vertigo and Tinnitus, www.seekingbalance.com.au

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