Pulsatile Tinnitus, Possibly a Side Effect of Medication?
It's a question many of us ask, especially when our pulsatile tinnitus began simultaneous to use of medication, prescribed
There haven't been too many studies on this possible relationship to pulsatile tinnitus
cases, generally, but one recent study looks specifically at fluroquinolone antibiotics, a specific family of medications,
and the possible relationship of their use to one specific known cause of pulsatile tinnitus: idiopathic intracranial hypertention
This recent study looks at a variety of the drugs in this category, including Levaquin. This summary reveals the process by which researchers searched databases for patients whose files indicated within a short period
of time the ICD code for IIH, imaging and other diagnostic testing that would confirm an IIH diagnosis, as well as a prescription
for the drugs within 15-30 days of the IIH diagnosis.
Basically, the study suggested an increased risk of IIH for users
of this family of medications.
These medications are no stranger to lawsuits, apparently. Just Google "Fluoroquinolone
Litigation" and you'll see the reports.
Now that pulsatile tinnitus has its own ICD code, the potential for monitoring our cases has improved. SO MUCH. However, we see even in this report that pulsatile tinnitus
is mentioned at the beginning of the abstract but then, it seems, it is referred to as tinnitus at the end of the abstract.
Pulsatile tinnitus is not tinnitus!
It may take a while for the pulsatile tinnitus code to be integrated generally
and in similar research studies, but we see in this study the signficance of proper identification of symptoms to research,
and the possibility that medications may play a factor in some pulsatile tinnitus cases, at least as they relate to this possible
As usual, consult a doctor with any questions about medications.
If you are experiencing pulsatile tinnitus, don't forget that there is a large community of pulsatile tinnitus "Whooshers"
on our active Facebook group page, including some diagnosed with Chiari. You're not alone!
I'm happy to be speaking about pulsatile tinnitus in Cleveland this weekend at the 10th Annual FMDSA Meeting! Learn more about Fibromuscular Dysplasia, one possible cause of pulsatile tinnitus. Click the informative video
Pulsatile tinnitus may be subjective (only the patient
can hear it) or objective (the patient AND others can hear it).
Sometimes objective pulsatile tinnitus can be heard with
Sometimes it can even be heard without a stethoscope, just by putting your ear next to the pulsatile tinnitus
It is repeated in the medical literature
that doctors should try to listen for the bruit (the sound) when a patient presents with pulsatile tinnitus. Sometimes
where the sound is located can be a clue as to the source. At the very least, hearing the sound gets the attention of medical
professionals and may speed up the inquiry as to the cause.
The right spot for the stethescope bell will vary by the patient, as the location of the source of the pulsatile
tinnitus differs from patient to patient.
a very helpful post with images from "Kate," one of the members of our very active Facebook group page, republished with her permission, on how to listen for the bruit with
"I made this to show where my bruit can be heard on my skull.
In December 2016
I was told by an ER doctor, when I asked him to listen to my skull,
"We don't listen there. There's nothing there
to listen to."
He would only auscult
my carotid on my neck and then told me my symptoms could be Meniere's or multiple sclerosis and they can't do much for
me except refer me to an ENT.
My personal experience/tips, as I am not a medical professional so I'm just
sharing what worked for me to find the objective noise:
The stethoscope is a pediatric stethoscope. The person I borrowed this from let me try their fancy top brand cardiac stethoscope
but the pediatric one worked best. It helps to press firmly but not too firmly. The sound volume changes with pressure.
I can find it easily but in noisy doctor offices it can be harder to hear and especially if the person listening just
quickly places the bell and moves it. It's louder in certain spots so patience and careful listening for at least 10
seconds in each spot is important in my opinion. Also, doing jumping jacks to make it louder helped my doctor the first
time to find it. The second time she didn't need me to do jumping jacks because she knew what she was listening for.
As Whoosh Whoosher has said, not everyone with PT has objective PT/bruit and the absence of one doesn't change the validity of your PT.
Docs should take all PT seriously. In my experience, finding the bruit just really helped as far as having them
take it seriously and sped up the process.
sure you check with different postures and head positions in case the whoosh varies by these factors. For example, mine is
usually silent/quiet/gurgly when laying flat, louder when tilting head to opposite shoulder of PT ear and quieter when
tilting head to PT ear.
I really think the important things are to have a silent place to listen, a patient listener,
and a good, smaller-sized stethoscope (which also helps very specifically locating the loudest point).
Other factors, once I found my whoosh, that I noticed influence the sound are things
like valsalva maneuver, holding breath, pressing artery/veins, etc. I've experimented with pressing on my carotid and jugular
on both sides as well as the blood vessel on the back of my neck which I think might be the occipital artery.
I am hoping this information will be useful for
the doctors and perhaps clue them to anatomical areas to focus on when looking at my scans."
Be sure to see the Sounds page on this site for more images and links to audio of real whoosh sounds, recorded by real whooshers!
Peter Mansfield, M.R.I. Pioneer and Nobel Laureate, Dies at 83
Sometimes it's easy to forget that we are indebted to some of the pioneers in medicine who take a chance and create something
that will endure their lifetimes and help more people than they ever could have imagined!
Sir Peter Mansfield, whose
research led to the invention of MRI, died February 8, 2017.
While an MRI can't detect each and every possible cause
of pulsatile tinnitus, it can detect many of them. A number of people in our community, including Yours Truly, are pretty
glad Sir Mansfield was born!
Read more about Sir Peter Mansfield's amazing life and discoveries here, from the New York Times.
We are conducting this survey to better understand
the impact that pulsatile tinnitus has on people's lives in terms of depression, anxiety, and function. We hope that this
information will help guide us in terms of providing better care for our patients and raising awareness of pulsatile tinnitus
as an illness.
Use code SILENTNIGHT for 25% off US orders of $50 or more. Includes free shipping. Using this link your order will
provide a portion of proceeds to our Whooshers.com community! Good through Friday, December 2, 2016!