The neurologic implications of tinnitus

One hundred twenty-one patients with chronic tinnitus were examined for associated neurologic lesions. A routine otologic evaluation was supplemented by an extensive neurologic evaluation, which usually included computed tomography with special views of the posterior fossa. Twenty-one percent of these patients had neurologic disease that appeared to be responsible for the tinnitus. Twenty-three percent had neurologic problems associated with or evolving in concert with the tinnitus, but the auditory complaint could not be confidently ascribed to the CNS disease. Several patients had neurologic or psychiatric problems uncovered during the evaluation that were clearly unrelated to the auditory complaint. The high incidence of neurologic disease in association with tinnitus indicates that tinnitus is often an early sign of CNS disease. Chronic tinnitus justifies a rigorous neurologic evaluation of the affected person regardless of the character of the tinnitus.