QA family member has been unable to leave the house because of severe vertigo that results in nausea and discomfort. What is it and what might help?

A The disorder is called cochlear hydrops, and it also involves hearing problems. Sometimes called atypical Ménière’s disease, it is caused by abnormally high fluid pressure in the part of the inner ear called the cochlea, which is involved in both balance and hearing. Pressure surges bombard the sensitive nerve endings that normally transmit information about the body’s position to the brain.

Besides causing bouts of vertigo to the point of nausea and hearing problems, cochlear hydrops leads to a sense of fullness in the ear and ringing, or tinnitus, often described as a low-pitched roar. These symptoms sometime precede full-blown vertigo.

The cause is not always easy to identify. The problem can be associated with autoimmune disorders like lupus; with hormonal surges, especially in women, who make up somewhat more than half the sufferers; and with allergic attacks. Dietary changes often help avert attacks of vertigo. A low-salt diet and diuretics can also help control the fluid pressure. Anti-inflammatory drugs like steroids are usually helpful. Different kinds of surgery have been tried when medical treatment fails, but the methods are controversial.

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