Autoimmune inner ear

[me2]

For some reason I can't paste here to start this thread. I will try and post this and then see if I can paste as I usually can. (I was a paste eater as a kid, maybe this is my punishment)

[me2]

Hey it worked , I can now paste. During my research this AM I ran across this article I thought was interesting. Not really shedding new light maybe but sometimes it helps to see a different source for info.

Curr Opin Otolaryngol Head Neck Surg. 2004 Oct;12(5):426-30.
Autoimmune inner ear disease.

Ruckenstein MJ.
Department of Otorhinolaryngology, Head and Neck Surgery, University of Pennsylvania, 3400 Spruce Street, 5 Ravdin, Philadelphia, PA 19104, USA. [email protected]
Abstract

PURPOSE OF REVIEW: The role of the immune system in mediating inner ear pathology has received considerable attention over the past two decades. The purpose of this paper is to summarize recent basic science research into the pathogenesis of autoimmune inner ear disease (AIED), review the current diagnostic work-up for patients with suspected AIED, and delineate treatment strategies. RECENT FINDINGS: Basic science and clinical studies have been performed to delineate the mechanisms by which autoimmune processes may affect the ear and to develop treatment strategies to reverse this pathology. AIED refers to a rapidly progressive (over a course of weeks to months) sensorineural hearing loss that responds to the administration of corticosteroids. In addition, systemic autoimmune diseases (eg, vasculitides, lupus, Wegener granulomatosis) can secondarily affect the inner ear. Although a number of diagnostic tests for AIED have been advocated, the diagnosis of this entity is still predicated on a positive therapeutic response to corticosteroid administration. Alternate immunosuppressive regimens, designed to be used in patients who cannot be weaned off corticosteroids or whose disease becomes refractory to treatment, have proven to be difficult to develop. Methotrexate, which initially showed promise, has recently been shown to be ineffective in preventing progression of hearing loss. Further research is required to better delineate the pathophysiologic mechanisms involved in AIED and to establish more effective and better tolerated treatment regimens. SUMMARY: The original enthusiasm that was generated by the concept that immune-mediated mechanisms may mediate reversible forms of inner ear pathology has been tempered by the realities conveyed by scientific research. The pathophysiology of AIED is still not well understood. Multiple potential mechanisms have been identified that can result in immune-mediated inner ear pathology. The diagnosis of AIED is based on clinical presentation and response to the administration of corticosteroids. Diagnostic testing may support the diagnosis, and the results of a recent multicenter study should clarify the role of immunologic testing in the diagnosis of this entity. Treatment options are limited, with corticosteroids being the only validated treatment option, and methotrexate offering no significant benefit to patients. The role of cyclophosphamide is restricted to patients willing to endure the attendant risks. With the advent of cochlear implants, the administration of toxic medications to preserve hearing at all costs is a less desirable option.
PMID: 15377956 [PubMed - indexed for MEDLINE]

[Sangye]

Great article, me2--thanks for posting.

[me2]

I thought it might interest you. I didn't know anything about the subject until you shared what you were going through.

[Sangye]

I didn't know about it either! The docs say mine certainly could be autoimmune-related, but because there were numerous people at our temple who got the same thing (vertigo) at the same time, I think a straightforward inner ear virus is the more likely culprit. None of them got the hearing loss, though and none had the severe vertigo like I did. It lasted 3 weeks to 2 months for most of them.

Both the otologist and the vestibular rehab doc said it's hit or miss. The vestibular nerve (balance, vertigo) and the cochlear nerve (hearing) are adjacent to one another and then fuse. If a virus or autoimmune process affects that tiny area, the inflammation can cause vertigo and/or hearing loss and/or tinnitus. I like to buy in bulk, so I bought the full package.

[me2]

Some times its best to buy things seperately when they are on sale. That way you might find you might not even want one of the things by the time it is available. Overly simplistic advice I know , I'm just saying avoid impulse aquisition of problems.

[DEE]

Sangye in the uk its buy one get one free !!! in the stores you obviously get more
maybe just get one thing at a time and try before you buy !!!
Rake care DEE x

[elephant]

Poor Sangye had no choice, it was all wrapped up in steel and the WG dog was laying right there!

[Sangye]

LOL-- You guys are so funny!

[DEE]

opps sorry
Rake care DEE x[/QUOTE] meant take care not RAKE cant see letters on left side off key board so good at the moment !!!!!

yes Sangye im getting sorted got telephone appointment withwg consult wednesday when he comes back of holidays DEEx