Head-spinning Meniere's disease may have met its match

University of Washington

Gene Pugnetti, left, takes a look at a new device aimed at stopping the severe vertigo of Meniere's disease.This week, the Yakima, Wash., man became the first person to be implanted with the invention. With him is his wife, Phyllis, and audiologist Elyse Jameyson.

Dizzy doesn’t begin to describe Gene Pugnetti’s bouts of vertigo.

For at least four years, the 56-year-old Yakima, Wash., man has suffered repeated episodes of stomach-lurching, head-spinning disruptions in his equilibrium, attacks so severe that they require him to sit down, cover his eyes and wait an hour – until the Valium kicks in.

Just since February, Pugnetti has endured 45 such spells, all caused by what doctors diagnosed as a severe case of Meniere’s disease, an inner ear disorder that erodes victims’ hearing and leaves them vulnerable to unexpected vertigo. The most recent bout was three weeks ago.

“It was pretty bad,” said Pugnetti, an information technology worker, who has 65 percent hearing loss in his right ear. “Just, bang!, you’re focusing on something and then all of a sudden you can’t focus on anything.”

Pugnetti has tried almost everything to quell the problem, which affects some 615,000 people in the United States, according to the National Institutes of Health. Drugs, diet, exercise and even an implanted shunt failed to do the trick.

On Thursday, though, Pugnetti became the first person to be implanted with a new device aimed at stopping the vertigo as soon as it starts. Dr. Jay Rubinstein and Dr. James Phillips of the University of Washington’s otolaryngology-head and neck surgery department, assisted by a team of experts, chose Pugnetti as the first member of a 10-person clinical trial to test an invention four years in the making.

It’s the “UW/Nucleus Vestibular Implant,” a clunky name for the behind-the-ear device that’s basically a revamped version of a cochlear implant, an electronic aid typically used to help deaf people hear. In Meniere’s, the disease short-circuits the power supply that allows balance, Rubinstein said. The new device restores it by sending electrical impulses to electrodes implanted in the bony ear, disrupting the vertigo.

Once it’s turned on, in about three weeks, Pugnetti will be able to don the device at the first sign of dizziness, disarming symptoms ranging from mild to severe.

It won’t eliminate the Meniere’s, for which there is no certain cause or cure, but it should get rid of the worst effect. If the clinical trial is a success, the device that was tested in monkeys and approved in June by the Food and Drug Administration could find a wide audience of Meniere’s victims, says Pugnetti, who has no qualms about being first.

“The fact is, there are a whole lot of people who are out there suffering,” he said. “Just talking about this procedure to them gives them hope. And that’s a big deal."

For information about the new device, call (206) 598-8896.

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WOW!!

No, I don't have Meniere's, but I do have equilibrium problems of another sort. If this device works for the equilibrium problems with Meniere's, it may work for all such problems. I can only hope, of course.

  • 2 votes
Reply#1 - Thu Oct 21, 2010 12:28 PM EDT

Meniere's is a major inconvenience for me. It appears to be associated with aerobic exercise and it causes nausea. Ginger seems to work for me. Anyone with this problem should try everything else before surgery.

  • 1 vote
Reply#2 - Thu Oct 21, 2010 12:42 PM EDT

There is no surgery for Meniere's. It is treated with sedatives - valium and meclazine are 2 of the most common. Ginger is definitely great for nausea, but it has no effect whatsover on vertigo.

    #2.1 - Thu Oct 21, 2010 2:09 PM EDT

    Cenzie there ARE surgeries that can be done but they are DRASTIC... vestibular nerve section (VNS) surgery, chemical ablasion, tubes, are some of them and I for one cannot even imagine doing those... Here is a link, down at the bottom is a listing of other surgeries available..

    http://www.menieresinfo.com/treatment.html

      #2.2 - Thu Oct 21, 2010 2:23 PM EDT
      Reply

      rpearlston - I assume that you have been thoroughly checked out by your physician. Dizziness and balance disorder can also be a sign of neurological disease. If you haven't already, please have your physician check this condition out. My father passed away from a neurological disease that started as dizziness and balance disorder. (It turned out that he had a degenerative neurological condition)

      If your physician can not find what is wrong, then look for a balance disorder specialist.

      If you would like more information, please visit my blog and PM me. I'd be more than happy to assist you in any way I can. (I'm not a doctor, however I spent three years studying these conditions when my father was sick.)

        Reply#3 - Thu Oct 21, 2010 12:45 PM EDT

        what was wrong with your dad> would like to know more

          #3.1 - Mon Oct 25, 2010 11:14 PM EDT
          Reply

          My mother has the full blown Meniere's disease with vertigo and is virtually deaf in one ear.. I have the starts of it but so far without the vertigo (excessive non draining fluid buildup with extreme headaches) ... No known cause and no "cure"... My mother was on FMLA for the last year she could work because of it.. it is a nasty damn disease. I would have to go pick her up from work because she would have an episode at work. Stress is a trigger which only makes it a vicious circle. Once she was "retired" and the stress lessened, her episodes reduced but she still has them, just not as often. I hope this works for this man.. it would be nice to see something promising by the time I am having the full blown disease.

            Reply#4 - Thu Oct 21, 2010 1:09 PM EDT

            I've also been diagnosed with Meniere's and while I don't have as much of the dizzies yet, I'm sure it's part of my future. I'm grateful to read that some kind of research is being done for this and that when it gets worse for me, I will have some options.

              Reply#5 - Thu Oct 21, 2010 1:13 PM EDT

              I was diagnosed with Meniere's in 1982 while pregnant. It started out slowly with the dizzy spells that would give me enough warning that I could drive home and get in bed. The spells became more frequent and with less warning so by 1984 after my second child was born, I knew I couldn't take the risk of attacks with my kids in the car. The doctor first decompressed the inner ear - that worked for about 6 months before the dizziness came back. I finally felt I had to take the last option that was offered. Surgery was done to clip the nerve in the brain that controlled the dizziness on the right side of my head. I have very little hearing but I don't battle the vertigo, vomiting, weakness and chills I had earlier. There were risks but I had to take that chance. Fortunately for me, surgery went well so all I have is the usual noise in my ear with major hearing loss. My hope and prayer is that I don't get it in my other ear. If this new implant works, it will be a blessing to so many.

                Reply#6 - Thu Oct 21, 2010 1:50 PM EDT

                I have had severe vertigo for over 6 years. I have been diagnosed with Meniere's, Labyrinthritis, "ear rocks," etc. Several years ago I was told by top ENT doctors in New York that "there was nothing" that could be done for me and that I would have to "learn to live with it." Well, I have, and with LOTS of practice I manage through the mild episodes and with LOTS of tears I stay in bed through the severe episodes. I was also, at one time a few years ago, a participant in a clinical trial for a year for an electronic device that stimulated your tongue. Unfortunately, this device was not effective for vertigo and was not approved. I cannot take any medication for my episodes as I am not "sedative-friendly" - they tend to drive me into a deep depression. I did use acupuncture for several years to subdue my symptoms, and I recommend that if you have not tried it thus far. It is expensive, however, and is very hard to get covered by health insurance. I am pleased to see that there is something new on the horizon and we dizzy-lizzys are not forgotten.

                  Reply#7 - Thu Oct 21, 2010 2:05 PM EDT

                  Hello Cenzie and all, I've never left comments on a post, but there's a first time for everything. For anyone who would like to learn about something that is not only effective with Meniere's, but can benefit your overall health so much, please send me an email, and I can share with you something that can change your life.

                  I'm a massage therapist, and always looking for natural ways to help my clients, and have discovered something that can help more than anything I've ever tried before. I have two friends who have Meniere's and this has helped them so much. They are feeling great and haven't had an episode since they began it!

                  Lynette@tds.net

                    #7.1 - Sun Oct 24, 2010 4:17 PM EDT

                    Lynette

                    I was diagnosed with Meniere's in October after experiencing symptoms for a year. I'm interested in understanding what you are doing to help your clients.

                    Deb

                      #7.2 - Sun Nov 14, 2010 2:11 PM EST
                      Reply

                      This is so exciting, where can I sign up? I am 33 and was diagnosed with Meniere's in my twenties. My ENT said he had never seen such a bad case in someone so young. Lucky me! Now I take a diurectic everyday and have to wear hearing aides. My dizziness is much less common now, but man, when it hits I'm out of commission for days! Not very convenient when you have 2 year-old twins to take care of! My mother also has Meniere's, but she hasn't had the dizziness that I have. I'm just grateful that with diurectics, a low-sodium diet and lots of water it's somewhat manageable.

                      I've also found that I'm more likely to have an episode if I haven't been sleeping enough, I'm stressed, or my allergies are acting up. Anyone else noticed that? The stress part is tough because being dizzy just makes you more stressed! Valium doesn't do much for my episodes, I just try to go to sleep. I do hope this device become available to more people soon. Any time you have a condition with no known cure, it tends to take a toll on you. It would be nice to at least have a treatment!

                      • 1 vote
                      Reply#8 - Thu Oct 21, 2010 2:31 PM EDT

                       I've had the disease since I was 18 years old. I'm now 46.  That's a lot of years to go through the vertigo and nausea. I went for years not being diagnosed because I thought it was all in my mind. I thought I was creating the symptoms like a hypocondriac.  Turns out both my mother and father have it and it's just something they never talked about, so apparently I inherited it from them.  It's just something I slug through but I have vertigo to varying degrees pretty much on a daily basis.  Sometimes it's very minimal but sometimes it's tough to move.  I take Dramamine or Mezcline on a daily basis just to manage the symptions. Still, I've been functional and I thank God for it, but the older I get, the worse the symptoms seem to get. A device like this, if it works, is an absolutely God-send. I don't even know what it's like not to be free of vertigo for a few days at a time. I can't imagine being able to stop symptoms as they get started. What a miracle.

                      • 1 vote
                      Reply#9 - Thu Oct 21, 2010 3:35 PM EDT

                            I have had Meniere's since 1985.  While the drop attacks have mostly slowed down,  I get short duration attacks ( BPPV).  I have tried duretics, valium, potassium, and other "remedies".  The best relief has been marijuana.  I limit my driving to the local town total distance less than 1 mile of 25 mph.  I hope the new technology works, but most attacks give no warning, it would have to be on all of the time.  Does that work?  Good wishes to all of you and your families because we don't suffer this alone.

                        Reply#10 - Thu Oct 21, 2010 4:23 PM EDT

                        After trying many things, my ear surgeon placed a small tube in my inner ear and also recommended that I take T-Bio, which contains ginger as well as the active ingredient in traditional (drowsy formula) Dramamine and several other ingredients I have not had an episode of dizziness and vomiting since and still take T-Bio now, about 5 years later. I would recommend it whole-heartedly. You can order it over the internet from a company in Florida. It makes me sleepy, so I take 2 capsules at night rather than splitting the dose and taking one in the AM and one in the PM. A bottle of 60 capsules lasts a month.

                          Reply#11 - Thu Oct 21, 2010 5:56 PM EDT

                          My thoughts are certainly with you all. I watched my father suffer from balance disorder until it put him in a wheelchair. Even though I do not suffer from balance issues, I have a lot of sympathy for anyone who does suffer from these conditions.

                            Reply#12 - Thu Oct 21, 2010 6:06 PM EDT

                             I have had this all of my life, but wasn't diagnosed until 5 years ago at 56. I remember as a child being in bed and spinning. Come to find out my father had it and never told us or talked about it. He took medication, don't know what. I thought I had a build up of ear wax and was embarassed to go to the ENT finally got so bad I went. . No wax just Meniere's. So if your child says he is spinning or dizzy or something about his ears have it checked out..Good luck to all....

                              Reply#13 - Thu Oct 21, 2010 6:08 PM EDT

                              I had extreme bouts of dizziness and the bed spinning for years...I drank 4 to 6 diet pops a day. I quit the diet pop and the dizziness went away...4 years and counting, no dizzies.

                                Reply#14 - Thu Oct 21, 2010 7:31 PM EDT

                                I was diagnosed with Meniere's 30+ years ago and have gone through several bouts intermittent over the years. A few years ago, after a particularly nasty episode, I went to a ENT who retested me and confirmed that I had Meniere's and benign positional vertigo. The BPV can be controlled with simple exercises done while lying flat in bed, but the Meniere's is a different story. He advised me to have a steroid infusion in the ear to reduce the swelling that causes the dizziness. I did that. He numbed the ear drum and used a needle to infuse steroids into the ear canal. I have not had a recurrence in at least 6 years. I know that this does not mean I never will again, because most of my attacks have come in clusters with several years in between bouts. But the steroid treatment seemed to work and it was a simple thing. However, if the M. returns i will consider this new treatment. For all those of you who have had this, you know how debilitating and frustrating it can be. Good luck.

                                  Reply#15 - Thu Oct 21, 2010 10:20 PM EDT

                                  I have suffered from Menniere's for 18 years, with it now in remission. Although, it never really is. I have found a daily regimin of Meclazine works best for me. I had a steroid injection several years ago, placed in a tube in my ear, which worked well, too. I am trying to keep it under control with diet and stress releasing exercises, but that's a challenge. I am very sympathetic to anyone who endures this awful disease. It has left me with virtually no hearing in my right ear and a hearing aid seems to help because it puts white noise in my ear, which distracts me from the other sounds that I am constantly hearing, i.e. helicopters or a phone hung up inside my head.

                                    Reply#16 - Fri Oct 22, 2010 10:14 AM EDT

                                    I don't have the vertigo yet (thank goodness) but my mother does... she said her noise was a constant buzzing sound... Mine is summer crickets, I know that sounds weird but that's what it sounds like to me...

                                      #16.1 - Fri Oct 22, 2010 10:42 AM EDT
                                      Reply

                                      I've also have Meniere's. It started ten years ago when I was 25. I didn't know the what it was the first time, since I just felt like vomiting while my ear had a swelling feeling. Then as time progressed I got vertigo attacks every once a year. I was not diagnosed until 3 years later. Continued with attacks twice a year, and now after ten years I had a really strong attack two weeks ago that left me in the hospital for four days. It was incredibly strong and disabling attack. And I am sure it did some major damage to my inner ear. Now I have tinnitus 24/7 in my left ear and I my balance is a little off. Now I am really scared for my safety and my future. I really fear ending up disabled and not able to work. I am just starting my career after many years to obtain my degree and now feel such a sense of loss. I hope to have luck and have it go into remission, but as we all know, this disease just keeps getting worse.

                                      I am comforted somewhat to learn that research is continuing on this problem and at least they have not forgotten us.

                                        Reply#17 - Sat Oct 23, 2010 5:50 PM EDT

                                         I do suffer from Meniere's - it started up about 3 months ago out of nowhere (I'm 49) - all I can do is take Meclizine when I begin to feel 'it' come on and hope that lessens the severity (of course, a side effect of taking the Meclizine is dizziness, so I trade all-out spinning with minor dizziness) - I sailed for years and now I'm afraid of a bout occuring in mid-sail - even on dry land, if I have a bout it lasts 4-5 hours. during which I can't do much but try to remain absolutely motionless - even tilting my head 1° can trigger the spinning again. Praying it just lessens on its own as time goes on! 

                                          Reply#18 - Mon Oct 25, 2010 2:48 PM EDT

                                          Wow, Wow, Wow!!! I'm keeping my fingers crossed. He is a real pioneer to try this. I pray that it works for him. Keep us posted.

                                          Lawanna Bean

                                          Garland, Texas

                                            Reply#19 - Mon Oct 25, 2010 9:14 PM EDT

                                             I was diagnoised by a Dr at the UW in the 80's I already was deaf in my left ear and I almost lost all of my hearing in my right he put me on a 900mg salt free diet, predisone, diretic, potasium as the directic stripped me of my potasium and he saved my hearing in my right I regained all of it. I went into remmission for years. About 10years ago I started loosing my hearing in my right again and I am with a 51% loss now I started my salt free diet but I can't stand taking the predisone and I can't take the directs as it makes me to dehydrated.  I was fortunate to have had a very good Dr back then.  He left while still treating me and took a research position in another state.  I just wanted everyone to know that is how I was treated and what I am doing in order to try to save my hearing now in case it might help someone.

                                              Reply#20 - Tue Oct 26, 2010 1:38 AM EDT

                                              I also want people to know I was in a car accident and it took them a year to figure out what was wrong with me as I was having dizzyness and nauseousness problems I went to my ear Dr since I had meneires and he determined that it was not that but it was similiar it was migraine associated vertigo which instead of manifesting itself in migraines it caused you to be off balance, dizzy and have vertigo but it is very similar to meniere's disease. How they treat it is with topamax as they have to treat it as a migraine although the syptoms are not that of a migraine that stumped by primary dr, my neroulogist, and other specialist before they figured that one out so if you have problems and it is not meniere's check that out

                                                Reply#21 - Tue Oct 26, 2010 1:45 AM EDT

                                                This device sounds like a potential Godsend.

                                                My Meniere's diagnosis was in 1994. I've always had a lot of allergies & when my acute symptoms progressed to fullness in the ears & garbled hearing, my ENT referred me to an inner ear specialist. Two weeks later I had my first full blown Meniere's attack & after several hellacious tests the disease was confirmed. Within a year the disease became acute & debilitating, as I was having drop attacks on a daily basis. When the majority of my hearing was destroyed in the affected ear, my other symptoms gradually subsided & I was finally able to resume a normal life. It's been 8 years that I've been symptom free, but I know that I still have the disease & it could present itself again.

                                                I've never had a forum to talk about this experience & it feels good to find people who can relate.

                                                  Reply#22 - Wed Oct 27, 2010 12:11 AM EDT

                                                  My last severe vertigo attack from Meniere's was May 9, 2007. I use a diuretic daily, and follow an extremely low-sodium diet. The onset of Meniere's was gradual, over a period of a few years, beginning with hearing loss in one ear. I had labyrinthitis in my early 20s, and thought the dizziness was the same. My doctor sent me to an ear specialist who has written a booklet on Meniere's, along with two other doctors. He told me it is not curable, and I went into a depression. I also thought (mistakenly) that keeping my head immobile would help my vertigo. I eventually asked the ear doc if there are exercises that could strengthen my core muscles, and he sent me for physical therapy. What a godsend! I had about 6 weeks of therapy, learning exercises to do at home, including (unbelievable to me at first) rotating my head, walking while moving my head from side to side, and moving a ball in a full circle over my head and down, following it with my eyes all the while. It was hard, but I gained confidence and the ability to balance myself and keep my eyes focused. But the best thing I've done for myself is learn to read labels and keep my sodium intake low. And I'm a pain in the neck in restaurants, but there are times you must eat out and you just have to insist that you get food that is healthy for you. Hint: most fruit contains 0 sodium!

                                                    Reply#23 - Wed Oct 27, 2010 2:26 PM EDT

                                                    Anyone that may check back the University of Washing has completed their first cohear implant for menier's diesease. Check the UW site.

                                                    • 1 vote
                                                    Reply#24 - Tue Nov 2, 2010 9:17 PM EDT

                                                    I was diagnosed with Meniere's 10 years ago and had a such a bad episode that I called my doctor's office only to speak to a doctor an on-call that helped solve the problem. For me, it was too much salt in my diet. The water retention from salt was throwing my equilibrium off in my inner ears and giving me severe vertigo and ringing in my ears. The minute I reduced the salt in my diet, the vertigo stopped. I was so grateful that something so simple as reducing salt would cure this problem for me. As for others, I know it can be more severe. A co-worker who had sucha a severe case that he had to remove his inner ear and is deaf in one ear.

                                                      Reply#25 - Wed Nov 3, 2010 6:23 PM EDT
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