Tinnitus 1: The Panic Attack


  • A sensitive 26 y-o man working a stressful financial job was prescribed Celexa for depression, which resulted in an acute panic attack after a single dose
  • After a night’s rest he woke up with mostly left-sided tinnitus (some on the right)
  • He described the symptoms as high pitched and constant on the left, and like a diesel engine starting up on the right
  • His PCP sent him to an ER Psychiatrist, and he also had his ears cleaned
  • A hearing test revealed a loss of high pitch hearing on the left
  • An MRI revealed nothing serious, except an extra cervical rib on the left side

Evaluation, clinical reasoning & treatment strategizing

  • He came to see me 1 week after the onset, having stopped work because of cognitive impairment, fatigue and headache
  • Functional assessment revealed reduced cranial rotation to the right, indicating a tight right SCM and left OCI, and reduced lateral flexion down to the left
  • His mother became the tinnitus expert, leaving no stone unturned
  • I suspected Somatosensory tinnitus (ST) because I could influence the symptoms with resisted neck movements


  • At the top of my list was the left SCM (especially the clavicular head), followed by trapezius, scaleni, deep head of Masseter and the posterior neck muscles
  • This lead to a full, slow exploration of the extra-oral muscles, especially (funnily enough) the right lateral pterygoid
  • He tolerated the CRAFTA cranial holds well on the petrous part of the mastoid bone
  • He described the symptoms changing from a ‘fire alarm’ to a ‘dog whistle’
  • Next, I included the intra-oral routine, palatini, digastric drag, RCL, MFR of the ear and mastoid work
  • His Wednesday medical routine was to have a regular massage, a neuromuscular massage, followed by chiropractic

 and follow-up

  • He came to Myopain Solutions for a total of 11 NMT treatments over 10 weeks
  • His symptoms abated from a 5/10 to a 1.5/10, when I last saw him
  • Because of the perceived lack of sympathy from his employer he had quit his job
  • He was getting into Benson Henry mind/body, and John Sarno’s Mind/Body Prescription
  • In making follow-up enquiries with his mum I found out he now works in a less stressful job with a more understanding employer