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Carbamazepine responsive typewriter tinnitus from basilar invagination
Eui-Cheol Nam1, Ophir Handzel, Robert A Levine
1Department of Otolaryngology, College of Medicine, Kangwon National University, Chunchon, Korea.
Journal of Neurology, Neurosurgery, and Psychiatry
|April 3, 2010
Summary
Basilar invagination, a congenital disorder, kinked the brainstem and auditory nerves, causing clicking tinnitus. This tinnitus symptom responded effectively to carbamazepine treatment.
Area of Science:
- Neurology
- Skeletal Biology
- Otolaryngology
Background:
- Congenital skeletal disorders can impact neurological structures.
- Basilar invagination is a rare condition affecting the skull base and cervical spine junction.
- Brainstem and cranial nerve involvement can lead to complex symptoms.
Observation:
- A patient presented with basilar invagination causing brainstem kinking at the ponto-medullary junction.
- This anatomical abnormality resulted in acute angulation of both auditory nerves at the porus acousticus.
- The patient experienced bilateral, asynchronous, clicking tinnitus.
Findings:
- The clicking tinnitus associated with basilar invagination and auditory nerve malformation showed a positive response to carbamazepine.
- This suggests a potential neuropathic or irritative component to the tinnitus in this specific anatomical context.
- Pharmacological intervention with carbamazepine can be a viable management option for such tinnitus.
Implications:
- Highlights the importance of considering structural abnormalities in the etiology of complex tinnitus.
- Demonstrates carbamazepine's efficacy in managing tinnitus linked to specific congenital neurological malformations.
- Suggests further research into the neurophysiological mechanisms of tinnitus in basilar invagination.
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