The Role of the Atlas in Vertigo and Meniere’s Disease


Vertigo is a false sensation that a person or his surroundings are spinning. It is the primary symptom of Meniere’s disease. Vertigo episodes caused by Meniere’s disease can be very severe and sudden. At least 100,000 Americans get the Meniere’s disease diagnosis every year. Meniere’s usually develops in people aged between 20 to 50 years old.

Meniere’s Disease Symptoms

  • Recurring and severe vertigo
  • Hearing loss
  • Tinnitus
  • A sensation of fullness in the affected ear
  • Nausea and vomiting

Getting Meniere’s Disease Diagnosis

The main method that doctors do to diagnose Meniere’s disease is through a hearing test. Doctors may suspect you have this condition if you display hearing loss in one ear and you also experience vertigo attacks

Another factor they consider is that your vertigo is not due to a change in your body or head position. If this were the problem, then it would mean you are suffering from benign paroxysmal positional vertigo (BPPV). The physician would very likely order an MRI (magnetic resonance imaging) to rule out any other serious causes.

Meniere’s Disease: What Causes This to Occur?

There is one prevailing theory of why Meniere’s disease develops: it is caused by the excessive build-up of fluid in the inner ear. However, this is not true for all cases of this disorder.

Let us discuss some insights about what happens to people with fluid build-up in their ears.

Housed within the inner ear are compartments called the labyrinth. The labyrinth houses the organs of balance composed of otolithic organs and the cochlea. It also has two sections – the bony labyrinth and the membranous labyrinth.

The membranous labyrinth contains endolymph. It is a fluid that helps the balance organs to detect movement. These receptors transmit information to the brain about the body’s current position, enabling proper spatial awareness. The endolymph becomes compressed in the cochlea in response to sound vibrations. After that, the signals travel to the brain by these sensory cells. For people with Meniere’s disease, the congestion of fluid interrupts the appropriate function and hearing. As a result, patients experience vertigo and other symptoms of Meniere’s disease.

Another Possible Cause of Meniere’s Disease

As mentioned above, there are some instances of Meniere’s disease where excess fluid build-up is not a factor in causing many other symptoms. A study has linked the connection between whiplash events involving the neck and head injuries to symptoms of Meniere’s.

Researchers discovered that a misalignment in the upper cervical spine can possibly result in Meniere’s disease. In addition, they learned that it would often take 15 years before a lesion starts to develop on the Eustachian tube. As a result, it can affect hearing and balance of a person.

What are the possible consequences of a lesion on the Eustachian tube?

  • It can interrupt the inner ear from draining fluid properly, which leads to excess fluid build-up
  • Dysfunction of the working of the inner ear

These facts call for a meticulous examination of patients’ medical histories. Doctors need to investigate head and neck trauma in particular. Sometimes, even a simple trip and fall accident in the past may have aftermaths 15 years later. Incidents such as car accidents and sporting injuries are usually the reasons behind the shifting of the atlas (C1) or axis (C2) vertebrae of the upper cervical spine out of alignment.

Managing Meniere’s Disease

After the confirmation of diagnosis, most doctors will recommend any of the following options:

  • Drugs to help lessen dizziness – Such drugs might include meclizine or lorazepam.
  • Drugs for vomiting – Your doctor might recommend prochlorperazine. 
  • Changes in dietary habits – You get a recommendation to reduce your salt intake, along with caffeine and alcohol. It may also be better for you to consume a diuretic (water pill). These suggestions can reduce the quantity of fluid that remains in your body and, therefore, reduce the incidence of Meniere’s disease.
  • Surgery – Some patients may benefit from it, but this is often the last resort when all other care options have already failed. 

There are more invasive procedures available for those individuals who find themselves disabled by chronic attacks of vertigo. The primary goal is to reduce the excess fluid in the inner ear or to destroy the internal ear structures. By doing this, it would help to maintain fluid balance in the ear.

The least invasive would be to have an endolymph sac decompression. Once this procedure is complete, the endolymphatic sac becomes exposed, and a flexible but thin sheet of plastic gets placed in the inner ear. However, if this procedure fails, you may have to undergo a process that will destroy the inner ear structures that are the cause of your symptoms. 

You will get injected with a gentamicin solution through the inner ear and into the eardrum. Gentamicin is selective in destroying the balance function before it can affect the hearing part of your ear. However, hearing loss is still going to be a risk to consider. 

The last procedure, surgery, is reserved for those with severe episodes of chronic vertigo. It is the last resort, a more invasive surgical procedure. It would involve cutting off the vestibular nerve to permanently eliminate the inner ear's ability to affect your balance.

The Link Between the Atlas Vertebra and Vertigo

The atlas vertebra is the top bone of your neck. It serves as a protection for the delicate spinal cord and the brainstem. The atlas bone allows the head to turn to various directions. However, due to its unique shape and features, it makes the atlas bone vulnerable to misaligning. What can cause it to shift out of proper alignment? Possible causes include:

  • Whiplash
  • Car accidents
  • Sporting injuries
  • Slip and fall
  • Neck and head trauma or injury

Because the atlas vertebra is near the brainstem, if misalignment occurs, it will put pressure on the brainstem. Excess stress and tension on the brainstem can cause it to send wrong signals to the brain. For instance, if the brainstem informs the brain that the body is moving when it is genuinely standing still, an episode of vertigo may happen. Therefore, it makes perfect sense that correcting this misalignment will also help lessen or eliminate vertigo attacks. 

Upper cervical chiropractors are highly trained to find these tiny misalignments in the upper cervical spine. They use a very gentle, low-force technique to encourage the bones to move back into place naturally. Many patients see relief from their vertigo and Meniere’s disease symptoms once the body gets a chance to heal correctly through upper cervical chiropractic. 

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The content and materials provided in this web site are for informational and educational purposes only and are not intended to supplement or comprise a medical diagnosis or other professional opinion, or to be used in lieu of a consultation with a physician or competent health care professional for medical diagnosis and/or treatment. All content and materials including research papers, case studies and testimonials summarizing patients' responses to care are intended for educational purposes only and do not imply a guarantee of benefit. Individual results may vary, depending upon several factors including age of the patient, severity of the condition, severity of the spinal injury, and duration of time the condition has been present.