Diagnosis of Tinnitus: Neurological Examination

1. There is an urgent need for a set of assessment methods to be agreed upon and utilized by the international tinnitus research community. 2. Neurological examination of tinnitus patients is essential to achieve a good diagnostic approach to the different forms of objective and subjective tinnitus. 3. This chapter summarizes the neurological examination in tinnitus, including the protocol used in the authors’ tinnitus clinic, which is based on the consensus of the Tinnitus Research Initiative (TRI).

Causes of Tinnitus: Cerebrovascular Diseases

1. Tinnitus can be divided into two broad groups: objective and subjective tinnitus. 2. Several layers of complexity are involved in the pathophysiology and the cause of tinnitus, and it is rarely known what causes an individual’s tinnitus. 3. Disorders that affect the brain are often accompanied by tinnitus. 4. Cerebrovascular diseases can be the cause of both objective and subjective tinnitus. 5. This chapter discusses cerebrovascular diseases as a cause of tinnitus and how it is produced.

Tinnitus Treatment: Botulinum Toxin

1. Somatosensory tinnitus (objective or subjective) is tinnitus that can be modulated by stimulation of the somatosensory system. 2. Abnormal interactions between the auditory and the somatosensory nervous system that may occur at several levels of the central nervous system cause somatosensory tinnitus. 3. This chapter discusses how administration of a ­botulinum toxin can alleviate tinnitus and the mechanism of its action, and how that relates to its effects on chronic pain. 4. A proven benefit of botulinum toxin in patients with objective tinnitus is also discussed.

Clinical Description of a Different Form of Tinnitus: Intermittent Tinnitus

1. Intermittent (paroxysmal) tinnitus is a form of non-pulsatile tinnitus. 2. An intermittent nature can be the only sign that intermittent tinnitus is different from other forms of tinnitus. 3. Intermittent tinnitus may be accompanied by irregular symptoms of other neurotologic disorders. 4. Both objective and subjective tinnitus may be intermittent. 5. A wide range of pathologies may cause intermittent tinnitus, but the cause of most forms is unknown.

Tinnitus with Headaches

1. Patients with tinnitus frequently have headaches, but the relation between these two disorders is not always casual. 2. Headaches and tinnitus could be symptoms of the same disease. 3. Idiopathic intracranial hypertension is a syndrome in which headaches and tinnitus often occur together. 4. Headaches and tinnitus often occur together with other focal symptoms in symptomatic intracranial hypertension. 5. Intracranial vascular abnormalities such as arteriovenous malformations (AVMs) can occur together with any kind of headache with paroxysmal tinnitus. 6. Tinnitus may be one of the signs of a basilar migraine. 7. Headaches are a very frequent symptom after head trauma, and tinnitus is als…

Recommendations for perioperative antiplatelet treatment in non-cardiac surgery. Working Group of the Spanish Society of Anaesthesiology-Resuscitation and Pain Therapy, Division of Haemostasis, Transfusion Medicine, and Perioperative Fluid Therapy. Update of the Clinical practice guide 2018

Bulbar impairment score and survival of stable amyotrophic lateral sclerosis patients after noninvasive ventilation initiation

There is general agreement that noninvasive ventilation (NIV) prolongs survival in amyotrophic lateral sclerosis (ALS) and that the main cause of NIV failure is the severity of bulbar dysfunction. However, there is no evidence that bulbar impairment is a contraindication for NIV. The aim of this study was to determine the effect of bulbar impairment on survival in ALS patients with NIV. ALS patients for whom NIV was indicated were included. Those patients who refused NIV were taken as the control group. 120 patients who underwent NIV and 20 who refused NIV were included. The NIV group presented longer survival (median 18.50 months, 95% CI 12.62–24.38 months) than the no-NIV group (3.00 mont…