dr/ khaled deif

Dear Dr/
I'm Egyptian cardiology specialist, 35 years old, live in Egypt ,1had given epidural steroid(diprophos) with local anathesia (Bucaine) injection for tt of disc prolapse at L5 -S1 at 28-6-2009 ,Unfortunately, dural lumbar puncture accidentally occurred that leading to severe headache associated with tinnitus ,that was relieved only in the supine position ,lasts for 1m then relieved after 1w bed rest admission in hospital ,but minimal continuous tinnitus continues, not related to position, Then tinnitus increased suddenly after a usual viral upper respiratory tract infection at 1-10-2009 and stressful conditions, continues till now. It is severe, continuous, very noising. Also I began to feel not hearing well in noisy places. , I tried wearing hearing aid, it decreased tinnitus somewhat, but I could not withstand it. I removed it.
Investigations done, treatment taken are attached with the message.
I like to consult you about my tinnitus, what is the cause, treatment, and prognosis, it decrease hearing, please I need your help very much.

Investigation done:
1-Brain MRI 22-7-2009 (before increasing of tinnitus): normal.
2- Pure Tone Audiometry since 5m, repeated now (same):bilateral mild to moderate gradual high frequency sensorineural hearing loss with excellent speech descrimination.see figure below.
3-Tympanogram: bilateral type A normal tympanogram with bilateral reflex elicitation suggesting bilateral normal middle ears. see figure below
4-Lab work: RBS, bilirubin, total protein,TGL,ALT AST, Uricacid,CK,LDH,Albumine,BUN,creatinine,CBC: normal, exc Cholestrol:222

Treatment taken before:
1-Diprofose im injection with oral prednisolon 60 mg for 10days with tapering(finished)
2- Magnesium oxide cap 400 mg od(for 3 months then stopped)
3- Betaserc(Betahistine hydrochloride)tab 16 mg tds for 4 months then stopped))
4- Trental (Pentoxyphelline)tab 400mg bid(for 1 month then stopped)
5- Thiotacid t tds, Neurobione tab od, Selenium t od (for 1 month then stopped)
6- Antioxident plus. 2 tab /d(for 3 months then stopped)
7- Diazepam 2.5 mg bid for 10 days
Current treatment I cached from net:
Ginkgo biloba 40 mg tds, nurobione tab tds, multivitamins with antioxidants tab OD, zink 25 mg bid, vitamin A 50,000 IU bid, Vinprocetine 10 tds, magnesium 400 od.
Tweet