Tinnitus in postherpetic neuralgia

Authors: Milena De Marinis Valter Santilli

Publish Date: 2010/02

Volume: 11, Issue: 1, Pages: 83-

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Abstract

We describe a woman who developed postherpetic neuralgia PHN located on the skin areas of the left ophthalmic division of the fifth cranial nerve without ocular involvement PHN was associated with tinnitus which was located ipsilaterally to the painful side and increased in proportion to the intensity of pain Tinnitus was responsive to treatment with duloxetine 60 mg daily and subsided when the PHN resolved This is the first description of tinnitus in PHNNeurootologic symptoms are common in migraine Vertigo and dizziness are reported by migraineurs as are phonophobia and lowfrequency hearing 3–6 By contrast tinnitus is not a common symptom in primary headaches 7 Moreover it is a well recognized though uncommon component of the RamsayHunt syndrome 8 To our knowledge there are no data in the literature on tinnitus in PHNWe describe a 65yearold woman who was referred to our outpatient unit because of severe head pain and atypical tinnitus In November 2007 the patient suffered an attack of high fever 39°C associated with cough myalgia anorexia headache and gastrointestinal symptoms She lost 6 kg in 10 days The nature of this fever and the cause of the symptoms associated with it were not investigated and remained unknown She had no history of any other significant past medical conditionsThe patient was promptly treated with antiviral therapy acyclovir 200 mg every 4 h for 7 days and the skin rash healed within 3 weeks The pain however persisted after the rash had resolved It manifested itself in a variety of ways including a deep aching pain sharp intermittent pain lancinating pain and allodynia It remained circumscribed to the skin areas innervated by the left ophthalmic division of the fifth cranial nerve

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