Vertigo and Ear clinic

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Tinnitus can be described as the sensation of sound heard by a patient. The sounds can be variously described as a buzzing, hissing & ringing, etc. This sound is defined as the conscious experience of sound that originates within the head of the listener, without any external source.
This sound sensation can be experienced in both ears, though often the patient is not sure about which ear the sound is coming from, & feels as though it is coming from the head.
The sound sensations arising out of tinnitus may vary in the type of sound, low & high pitches. It may be constant & intermittent or soft, loud or variable in intensity. 
Tinnitus is quite common, & is the most prevalent in older people. It is seen in both males & females, although males report more tinnitus cases overall.
Tinnitus is also associated with hearing loss, although it’s not always the case.
Read more about Tinnitus, its causes, diagnosis & treatment here. 

Tinnitus Causes:

There are many tinnitus causes. Some of the most common ones are:

Exposure to loud noise
Hearing loss related to old age or Presbyacusis
Wax inside the ear
Head injury or injury related to whiplash
Ear infections including Otitis media, secretory otitis, labyrinthitis
Certain drugs like aspirin, malaria-fighting drugs like quinine & chloroquine, antibiotics belonging to the mycin group- gentamycin & streptomycin, medications used in chemotherapy, & some diuretics, can cause a temporary or persistent Tinnitus
Medical conditions like hypertension, anemia, thyroid disorders & diabetes
Meniere’s disease
Cerebellopontine angle tumours like acoustic neuroma,
High caffeine intake
Alcohol consumption
Migraine headaches

For patients suffering from Tinnitus, it’s advisable that they undergo audiological & thorough medical evaluation to ascertain the cause of the disorder. 

There are multiple Tinnitus myths. With every patient that suffers from Tinnitus, there are many Tinnitus myths that they harbour. 
Most of these myths have their basis in the fact that a majority of people, including medical practitioners believe that tinnitus is untreatable, & that once you have it, you have to live with it forever. 

In this article, we are here to bust some popular myths around tinnitus, its causes & hearing loss among patients. Read on to know more.

Myth #1: There’s nothing you can do about Tinnitus!

Myth Bust: Many patients go to the doctor with complaints of ringing & buzzing in their ears but are turned away with the saying that there’s nothing that they can they do about it.  Most patients are told just to wait for it to go away on its own. 
However, this is a myth & there is a lot that you can do to treat & manage Tinnitus. 
Below are some proven ways to treat & manage Tinnitus. 

Tinnitus Sound Therapy: Sound is an important element in treating Tinnitus. Amplified sounds from hearing aids, environmental influences, music or noise generators can help minimize the effect from the constant ringing & buzzing in the patient’s ears. 

Ear Protection: Since exposure to loud noises is the leading cause of Tinnitus, earing ear protection masks & earbuds is a must for Tinnitus patients. 

Tinnitus Counseling: Assessment & counselling with an experienced healthcare professional trained in managing & treating Tinnitus in patients. Regular counselling & treatment can help patients live a healthy life & improve the quality of their life by treating tinnitus causes. The effects of Tinnitus can be lessened by a combination of counselling & treatment. 

 ZEN tones in hearing aid: ZEN tones have been known to give relief to Tinnitus patients. They work by amplifying environmental sounds & the sounds in nature to minimize the effect of ringing & buzzing in the patients’ ears. 

Relaxation exercises: Stress is known to increase the discomfort of Tinnitus patients. When you feel excessive discomfort, try destressing yourself by taking a walk, reading a book, watching TV, etc. 
Certain yoga postures also help to bring your stress levels down. 

Myth #2: Tinnitus is temporary & will go away on its own.

Myth Bust: Some forms of Tinnitus are temporary & are caused by sudden exposure to loud noise. Others, however, are more long-lasting & consist of recurring episodes. It’s important to remember that Tinnitus affects people in many different ways. According to the UK’s National Health Centre, ‘there are many sounds of Tinnitus’, including Mild Tinnitus, High-pitched Tinnitus, Low-frequency Tinnitus & Musical hallucinations. 
Some of these can & do last for a lifetime, albeit can be managed by different exercises & ear protection. 

Myth #3: Some pills can help cure Tinnitus.

Muth Bust: Some health companies will try to sell you a permanent cure for Tinnitus in the form of ‘magic’ pills. But medical science hasn’t yet gotten around to finding a cure for Tinnitus, so patients are advised not to fall for any of these scams. 

Myth #4: Tinnitus & Hearing Loss aren’t linked.

Myth Bust: Many Tinnitus patients will also experience Hearing Loss. A medical survey revealed that out of 123 patients, only one reported no hearing loss. The British Tinnitus Association states that around 90% of all Tinnitus patients experience hearing loss. 




Myth #5: If you don’t listen to loud music you won’t get Tinnitus.

Myth Bust: Loud exposure to music is just one cause of Tinnitus; there are several other causes. Even if you don’t listen to loud music, you might still get Tinnitus. 

If you’re experiencing ringing, buzzing, hissing in your ears, it’s advisable that you go for diagnosing & treating Tinnitus. 







If someone is suffering from Multiple Sclerosis it means there central nervous system is affected which is responsible for sending signals.
The central nervous the system is affected by a demyelinating disease known as Multiple Sclerosis (MS). Multiple Sclerosis has an auto-immune origin. The central nerve is protected and covered by the myelin sheath which helps in facilitating nerve conduction. In multiple sclerosis, patients may experience myelin sheath of nerve fibers are attacked by the body's immune system. The damage caused to the protective cover of the nerve may result in the disruption of nerve signals. Patients suffering from Multiple Sclerosis may experience several symptoms. You should advise your friend or family member who is experiencing symptoms of Multiple Sclerosis to seek medical help immediately to get the right treatment. An expert doctor will diagnose the disease closely asking you to undergo some tests. He may even seek your medical history for accurate diagnosis of the prevailing condition.
After examining your the condition he would suggest the best treatment for Multiple Sclerosis suiting your condition which focuses on a speedy recovery and manages the symptoms of multiple sclerosis. Mild symptoms of multiple sclerosis get resolved over time without any treatment whereas serious and persistent symptoms need to be treated on time.

Some common symptoms of Multiple Sclerosis

Patients suffering from multiple sclerosis may experience:

  1. Unsteadiness or instability
  2. Vertigo or spinning sensation
  3. Fatigue
  4. Blur vision or loss of vision
  5. Clumsiness or difficulty in coordination
  6. Slurring of speech or unclear speech
  7. Cognitive problems for Eg. difficulty in concentration and changes in memory


Some common diagnostic test carried by the doctor to examine Multiple Sclerosis

Here is a list of some common tests to diagnose the disease accurately:

1. MRI of brain

Brain MRI is a common test to diagnose multiple sclerosis. It helps in detecting the presence of plaques. The stage of the disease is closely determined after examining the location of plaques.

2. Evoked potential tests

 Stimulation of nerve pathways to map electrical activity within the brain. The evoked potentials used are visual, sensory and brainstem.

3. Spinal tap or lumbar puncture

 This is done to check for auto-immune antibodies.

4. Videonystagmography (VNG)

This test uses infrared cameras to track eye movements during different tests. MS patients may present with various eye signs like spontaneous nystagmus, ocular flutter, difficulty in holding the gaze, hyperventilation-induced nystagmus and direction-changing nystagmus.


Treatments for multiple sclerosis

1.Self-injectable treatment

In self-injectable treatment, certain medicines prescribed by doctors such as Beta interferons, Glatiramer acetate, etc. are injected by an injection to the body. It can be practiced at home after the proper guidance of the doctor to inject safely beneath the skin or directly into the muscles. It helps in reducing the frequency and severity of the disease.

2. Infusion treatment

Infusion treatment can’t be practiced at home it needs proper clinical settings. Infusion medicines like Ocrelizumab (Ocrevus), Alemtuzumab (Lemtrada), Natalizumab (Tysabri), Mitoxantrone (Novantrone), etc. can not be taken at home. Your doctor will advise you on the pros and cons of infusion treatments before starting it. The dosage for infusion medication varies from person to person depending on the severity of the underlying cause.

3. Oral treatment

As the name suggests its the simplest treatment for easing the symptoms of multiple sclerosis. It is an easy option than injecting needles or visiting clinics. Taking a course of prescribed medicines daily works effectively in treating multiple sclerosis. Fingolimod (Gilenya), Dimethyl fumarate (Tecfidera), Teriflunomide (Aubagio), Siponimod (Mayzent) are some of the common medicines prescribed by doctors to take regularly for treating the disease.

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A survey reports that 90% of people who suffer from the loss of hearing ability account for Sensorineural hearing loss. It can be mild, severe or permanent, it entirely depends upon the underlying cause and severity of the condition. Sensorineural hearing loss occurs due to the damage in the hair cells that are present in your inner ear or damage to the nerve, that crosses from the inner ear to the brain while carrying signals to the brain. Age factor is one of the most common causes of sensorineural hearing loss in people, but several other factors are responsible for the same.
Sensorineural hearing loss is categorized into two parts, congenital and acquired sensorineural hearing loss. Congenital hearing loss occurs during pregnancy due to various factors like prematurity, genetics, diabetes to the mother, lack of oxygen supply during the birth and so on. Whereas hearing loss that occurs after the birth can be caused due to various external factors like exposure to loud noise, injury, infection, side effects of certain drugs or age-related issues.

Some of the common causes of acquired sensorineural hearing loss
  1. Aging
Aging is the most important factor that is responsible for causing a hearing disability in a person. A study reports that a majority of people between the age group of 65-75 years are diagnosed with Sensorineural hearing loss. It occurs over time and affects both the ears of the person, which makes it quite difficult to get noticed.  
  1. Exposure to loud sound
Exposure to loud music or noise for an elongated period results in hearing loss. Exposure to sound louder than 85 decibels result in such a condition.
  1. Disease and infection
A person can experience sensorineural hearing loss if he/she is exposed to various diseases such as mumps, meningitis, multiple sclerosis, ménières disease, etc.
  1. Side effects of certain medicines
 A side effect of certain drugs like aspirin, cisplatin, quinine or the antibiotics streptomycin & gentamicin, can even cause certain infections and cause sensorineural hearing loss in a person.
  1. Tumors
 An abnormal skin growth in the middle ear leads to sensorineural hearing loss in a patient. Acoustic neuroma, a benign tumor is a common tumor that affects the auditory system and cholesteatoma.



Symptoms of sensorineural hearing loss
  1. A person may experience loud sound in one ear
  2. A person may experience difficulty in hearing in noisy areas
  3. Unable to hear women's voice
  4. Unable to recognize high-pitched sounds (such as "s" or "th") from one another
  5. When you start hearing unclear voices from other people
  6. If you are experiencing Meniere disease, you may start feeling dizzy or off balance.
  7. May hear a ringing or buzzing sound in the ears which (tinnitus)

In most cases, sensorineural hearing loss is permanent as the hair cells in the inner ear which are damaged, cannot be repaired or replaced. If one has experienced sensorineural hearing loss due to age factor its a permanent loss of hearing ability. Mild sensorineural hearing loss can be cured in some cases if medical help is taken immediately. An expert doctor will diagnose the underlying treatment before suggesting the treatment for sensorineural hearing loss. Patients who are diagnosed with mild acquired sensorineural hearing loss can be treated by wearing hearing aids. Whereas those with severe sensorineural hearing loss will be treated with cochlear implants. It is an electronic hearing device that is surgically implanted directly into the inner ear. Your doctor will advise on the risks and benefits before implantation. Seek medical help as soon as you start experiencing symptoms of sensorineural hearing loss to prevent it from getting severe.

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How can you help someone with Multiple Sclerosis?





If someone is suffering from Multiple Sclerosis it means there central nervous system is affected which is responsible for sending signals.

The central nervous system is affected by a demyelinating disease known as Multiple Sclerosis (MS). Multiple Sclerosis has an auto-immune origin. The central nerve is protected and covered by the myelin sheath which helps in facilitating nerve conduction. In multiple sclerosis, patients may experience myelin sheath of nerve fibers are attacked by the body's immune system. The damage caused to the protective cover of the nerve may result in the disruption of nerve signals. Patients suffering from Multiple Sclerosis may experience several symptoms. You should advise your friend or family member who is experiencing symptoms of Multiple Sclerosis to seek medical help immediately to get the right treatment. An expert doctor will diagnose the disease closely asking you to undergo some tests. He may even seek your medical history for accurate diagnosis of the prevailing condition.


After examining your condition he would suggest the best treatment for Multiple Sclerosis suiting your condition which focuses on a speedy recovery and manage the symptoms of multiple sclerosis. Mild symptoms of multiple sclerosis get resolved over time without any treatment whereas serious and persistent symptoms need to be treated on time.




Some common symptoms of Multiple Sclerosis


Patients suffering from multiple sclerosis may experience:


Unsteadiness or instability


Vertigo or spinning sensation


Fatigue


Blur vision or loss of vision


Clumsiness or difficulty in coordination


Slurring of speech or unclear speech


Cognitive problems for Eg. difficulty in concentration and changes in memory


Some common diagnostic test carried by the doctor to examine Multiple Sclerosis

Here is a list of some common tests to diagnose the disease accurately:









1. MRI of brain

Brain MRI is a common test to diagnose multiple sclerosis. It helps in detecting the presence of plaques. The stage of the disease is closely determined after examining the location of plaques.











2. Evoked potential tests

Stimulation of nerve pathways to map electrical activity within the brain. The evoked potentials used are visual, sensory and brainstem.












3. Spinal tap or lumbar puncture



This is done to check for auto-immune antibodies.






4. Videonystagmography (VNG)

This test uses infrared cameras to track eye movements during different tests. MS patients may present with various eye signs like spontaneous nystagmus, ocular flutter, difficulty in holding the gaze, hyperventilation-induced nystagmus and direction-changing nystagmus.





Treatments for multiple sclerosis


1.Self-injectable treatment


In self-injectable treatment, certain medicines prescribed by doctors such as Beta interferons, Glatiramer acetate, etc. are injected by an injection to the body. It can be practiced at home after the proper guidance of the doctor to inject safely beneath the skin or directly into the muscles. It helps in reducing the frequency and severity of the disease.




2. Infusion treatment

Infusion treatment can’t be practiced at home it needs proper clinical settings. Infusion medicines like Ocrelizumab (Ocrevus), Alemtuzumab (Lemtrada), Natalizumab (Tysabri), Mitoxantrone (Novantrone), etc. can not be taken at home. Your doctor will advise you on the pros and cons of infusion treatments before starting it. The dosage for infusion medication varies from person to person depending on the severity of the underlying cause.




3. Oral treatment


As the name suggests its the simplest treatment for easing the symptoms of multiple sclerosis. It is an easy option than injecting needles or visiting clinics. Taking a course of prescribed medicines daily works effectively in treating multiple sclerosis. Fingolimod (Gilenya), Dimethyl fumarate (Tecfidera), Teriflunomide (Aubagio), Siponimod (Mayzent) are some of the common medicines prescribed by doctors to take regularly for treating the disease.


What is Treatment of Acoustic Neuroma?

Acoustic neuroma is also known as vestibular schwannomas or neurolemmomas. Acoustic neuroma is a result of a slow-growing non-cancerous tumour of the vestibular nerve. The vestibular nerve is responsible for sending sensory signals from the inner ear to the brain which helps in maintaining balance and for hearing. The blockage in the vestibular system results in making the person feel dizzy or off-balance. The nerve is even responsible for hearing, the inflammation or disorder in the vestibular nerve can cause hindrance in hearing, resulting in hearing loss and tinnitus (ringing in the ear). Acoustic neuromas start growing slowly in the later stage, but you may start experiencing symptoms quite suddenly. The large tumour affects the brain stem or cerebellum, by gradually exerting some pressure on the brain, however, they do not damage the brain. The tumour does not spread in the other part of the body but the large tumours can prove to be a life-threatening cause for the patients. It even presses nearby cranial nerves that are responsible for controlling the muscles of facial expression and sensation. A large percentage of people between the age limit ranging from 30 to 60 years are diagnosed with Acoustic neuroma every year. Sometimes patients take some time in diagnosing the symptoms as the tumour grows slowly. Hearing loss in either of the ears, ringing sensation known as tinnitus, Facial numbness, weakness or a feeling of tingling on the face, Unsteadiness or loss of balance are some of the common symptoms of Acoustic neuroma or neurolemmomas. If the case becomes complex or has entered the later stage, patients of Acoustic neuroma may experience some symptoms like change in taste, change in voice, difficulty in swallowing & so on. It is advised to seek medical help immediately as soon as you start observing any Acoustic neuroma symptoms. Treating the condition on time helps in curing the condition. Your doctor will diagnose the underlying condition and would suggest the right treatment for the same accordingly. 

Diagnosis and treatment for Acoustic Neuroma

As you visit a medical professional after experiencing symptoms of Acoustic Neuroma, your doctor would ask you to undergo various tests like Videonystagmography (VNG), Audiometry, MRI, etc. for examining and evaluating the underlying condition and the size of the tumour. The accurate diagnosis of such a condition helps in getting the right treatment. The growth of Acoustic Neuroma tumours is monitored through serial MRIs. 
Before suggesting the treatment your doctor will seek the complete medical history along with the age of the patient. In some rare cases, if the tumour is small doctors may ask for watchful waiting and would recommend no further action. Your doctor will suggest the treatment of Acoustic Neuroma depending on the underlying condition and the size of the tumour. He would recommend surgery and radiation if tumours are causing symptoms of compression.
Surgery depends on the intensity of hearing loss, size of the tumour and the general condition of the patient. Whereas radiation is used to shrink and kill the tumour cells of the vestibular nerve.
Before doctors suggest radiation for treating Acoustic Neuroma, he would check the size and shape of the tumour along with the age and medical history. Radiation is often advised if the tumour can’t be decreased in size surgically.

 

 A survey reports that 90% of people who suffer from the loss of hearing ability account for Sensorineural hearing loss. It can be mild, severe or permanent, it entirely depends upon the underlying cause and severity of the condition. Sensorineural hearing loss occurs due to the damage in the hair cells that are present in your inner ear or damage to the nerve, that crosses from the inner ear to the brain while carrying signals to the brain. Age factor is one of the most common causes of sensorineural hearing loss in people, but several other factors are responsible for the same.
Sensorineural hearing loss is categorized into two parts, congenital and acquired sensorineural hearing loss. Congenital hearing loss occurs during pregnancy due to various factors like prematurity, genetics, diabetes to the mother, lack of oxygen supply during the birth and so on. Whereas hearing loss that occurs after the birth can be caused due to various external factors like exposure to loud noise, injury, infection, side effects of certain drugs or age-related issues.

Some of the common causes of acquired sensorineural hearing loss
1.    Aging
Aging is the most important factor that is responsible for causing a hearing disability in a person. A study reports that a majority of people between the age group of 65-75 years are diagnosed with Sensorineural hearing loss. It occurs over time and affects both the ears of the person, which makes it quite difficult to get noticed.  
2.    Exposure to loud sound
Exposure to loud music or noise for an elongated period results in hearing loss. Exposure to sound louder than 85 decibels result in such a condition.
3.    Disease and infection
a person can experience sensorineural hearing loss if he/she is exposed to various diseases such as mumps, meningitis, multiple sclerosis, ménières disease, etc.
4.    Side effects of certain medicines
 A side effect of certain drugs like aspirin, cisplatin, quinine or the antibiotics streptomycin & gentamicin, can even cause certain infections and cause sensorineural hearing loss in a person.
5.    Tumors
 An abnormal skin growth in the middle ear leads to sensorineural hearing loss in a patient. Acoustic neuroma, a benign tumor is a common tumor that affects the auditory system and cholesteatoma.

Symptoms of sensorineural hearing loss
1.    A person may experience loud sound in one ear
2.    A person may experience difficulty in hearing in noisy areas
3.    Unable to hear women's voice
4.    Unable to recognize high-pitched sounds (such as "s" or "th") from one another
5.    When you start hearing unclear voices from other people
6.    If you are experiencing Meniere disease, you may start feeling dizzy or off balance.
7.    May hear a ringing or buzzing sound in the ears which (tinnitus)

Treatment of sensorineural hearing loss
In most cases, sensorineural hearing loss is permanent as the hair cells in the inner ear which are damaged, cannot be repaired or replaced. If one has experienced sensorineural hearing loss due to age factor its a permanent loss of hearing ability. Mild sensorineural hearing loss can be cured in some cases if medical help is taken immediately. An expert doctor will diagnose the underlying treatment before suggesting the treatment for sensorineural hearing loss. Patients who are diagnosed with mild acquired sensorineural hearing loss can be treated by wearing hearing aids. Whereas those with severe sensorineural hearing loss will be treated with cochlear implants. It is an electronic hearing device that is surgically implanted directly into the inner ear. Your doctor will advise on the risks and benefits before implantation. Seek medical help as soon as you start experiencing symptoms of sensorineural hearing loss to prevent it from getting severe.