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Autoimmune sensorineural hearing loss/Meniere's disease possibly triggered by neurocysticercosis: a case report
Hamza Arman Lateef1, Evan Davies2, Alidad Arabshahi3
1Harvard College, Cambridge, MA, US. armanlateef@college.harvard.edu.
Background:
Meniere's disease arises when an abnormal fluid accumulation results in heightened pressure within the inner ear or labyrinth. Its symptoms encompass vertigo, tinnitus, hearing loss, and a sensation of fullness in the ear. Various triggers for Meniere's disease are known, from smoking and alcohol consumption to recent viral illnesses, allergies, and anxiety. Meniere's disease presenting as a postinfectious inflammatory condition secondary to parasitic disease is unknown.
Case Presentation:
A 37-year-old Hispanic male patient, native to southern Honduras, presented with dizziness and tinnitus. These symptoms progressed to include left-sided sensorineural hearing loss. The patient was clinically diagnosed with Meniere's disease and referred to an otolaryngologist. Laboratory work-up revealed a positive result for the anti-heat shock proteins antibody and abnormal electrocochleography, more prominent on the left than the right. His vestibulonystagmogram displayed both central and peripheral findings, and bithermal caloric irrigations suggested abnormal peripheral function with a 57% weakness in the left ear. Despite dietary and lifestyle modifications, as well as treatment with oral steroids, his symptoms persisted. More detailed history revealed that he had been treated for a tapeworm infection at the age of 14 years in his Honduran village. Subsequent magnetic resonance imaging scans of the brain highlighted postinflammatory calcification in the right parietal lobe and generalized volume loss, more substantial than what would be expected for the patient's age. The patient was also referred to rheumatology and neurology, where he was diagnosed with neurocysticercosis.
Conclusion:
To the authors' knowledge, this is the first report suggesting that Meniere's disease could be possibly triggered by or concurrent with neurocysticercosis. This highlights the need for a comprehensive examination to identify any coexisting neurological conditions in patients presenting with Meniere's disease.
Insights
This case report suggests neurocysticercosis may trigger Meniere's disease. Further examination is needed to identify coexisting neurological conditions in Meniere's disease patients.
Area of Science:
- Neurology
- Otolaryngology
- Infectious Diseases
Background:
- Meniere's disease is characterized by inner ear fluid imbalance, causing vertigo, tinnitus, and hearing loss.
- Known triggers include lifestyle factors and infections, but parasitic disease links are undocumented.
- This study explores an atypical presentation of Meniere's disease.
Purpose of the Study:
- To report a unique case of Meniere's disease potentially linked to neurocysticercosis.
- To highlight the importance of thorough patient evaluation for neurological comorbidities.
Main Methods:
- A 37-year-old male with Meniere's disease symptoms underwent clinical and laboratory evaluation.
- Diagnostic tools included electrocochleography, vestibulonystagmography, and brain MRI.
- Patient history revealed a prior tapeworm infection.
Main Results:
- The patient exhibited Meniere's disease symptoms and positive anti-heat shock proteins antibody.
- Neuroimaging revealed postinflammatory calcification and volume loss, indicative of neurocysticercosis.
- Standard Meniere's disease treatments were ineffective.
Conclusions:
- This is the first reported instance suggesting Meniere's disease may be triggered by or concurrent with neurocysticercosis.
- Comprehensive neurological assessments are crucial for patients with Meniere's disease.
- Parasitic infections should be considered in the differential diagnosis.
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