Presentation
- 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
Treatment
- 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
Results 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