Ménière's syndrome: two stories

Excerpt from the chapter “Other applications and their results” of the book TOMATIS — Une expérience à partager (TOMATIS — An Experience to Share, by Juan Antonio Timor Pineda and Chaime Marcuello Servós). Presented without naming the patients, out of respect for their privacy.

Ménière’s syndrome combines intense vertigo, hearing loss and tinnitus; it arises without warning and can reduce one to incapacity. The book reports two journeys.

A woman of about fifty lived confined to her bed, the vertigo preventing her from getting up, from driving, from working. After some sixty Tomatis sessions, the vertigo had disappeared; her hearing loss in the left ear had markedly diminished, and the tinnitus had become imperceptible. Beyond the physical improvement, the authors note a change in the way she looked upon her own life.

A young man in his twenties, with an exemplary university record and a frenetic pace of life, had found himself one morning unable to get up. Two months of specialist consultations had changed nothing. By the thirtieth session, the authors write, he had recovered his life — and understood something the doctors had not told him: his body had spoken before he did.

What the science says

These two accounts are moving, but Ménière’s disease has a particular feature that forbids drawing any proof from them: it progresses in attacks, with spontaneous remissions. The vertigo can disappear of its own accord, for months or years, independently of any treatment — spontaneous remission is estimated at more than half of patients at two years. An improvement after thirty or sixty sessions therefore says nothing about the cause: it may simply coincide with a natural remission.

Added to this is a particularly high placebo effect on vertigo (of the order of 60%), which makes trials very hard to interpret. That is why, in this fluctuating condition, only controlled trials would allow any conclusion; yet none shows an effect of the Tomatis method on Ménière’s syndrome.

The method may accompany a person’s experience; but Ménière’s syndrome is a matter for ENT follow-up, which a felt improvement should not lead one to interrupt.

Sources

• “Therapeutic illusion: another frontier in Ménière’s disease” — spontaneous remissions and a high placebo effect making effectiveness hard to prove.
• Natural history vs. surgery for Ménière’s disease (Silverstein et al.) — spontaneous remission of about 57% at 2 years and 71% at 8 years.