Tinnitus: Characteristics, Causes, Mechanisms, and Treatments

Tinnitus-the perception of sound in the absence of an actual external sound-represents a symptom of an underlying condition rather than a single disease. Several theories have been proposed to explain the mechanisms underlying tinnitus. Tinnitus generators are theoretically located in the auditory pathway, and such generators and various mechanisms occurring in the peripheral auditory system have been explained in terms of spontaneous otoacoustic emissions, edge theory, and discordant theory. Those present in the central auditory system have been explained in terms of the dorsal cochlear nucleus, the auditory plasticity theory, the crosstalk theory, the somatosensory system, and the limbic and autonomic nervous systems. Treatments for tinnitus include pharmacotherapy, cognitive and behavioral therapy, sound therapy, music therapy, tinnitus retraining therapy, massage and stretching, and electrical suppression. This paper reviews the characteristics, causes, mechanisms, and treatments of tinnitus.

Intractable Hiccup Induced by Multiple Cerebral Infarct: A case report

Hiccup can be regarded as a failure of the usual alternating excitation-inhibition between glottis closure and inspiration. The coordinating center is located in the brain-stem reticular formation. A wide variety of pathological conditions can cause intractable hiccup: myocardial infarction, brain tumor, renal failure, prostate cancer, abdominal surgery, etc. Stroke is an unusual cause of intractable hiccup. Intractable hiccup is rare but disabling condition which can induce depression, weight loss, sleep deprivation, and even death. Etiological treatment is not always available and intractable hiccup treatment has classically relied on metoclopramide and chlorpromazine. We experienced a case of intractable hiccup induced by multiple cerebral infarct, and we present this rare case with the review of literature.

Seizure Induced by Photosonic Device

BACKGROUND & SIGNIFICANCE: Photosensitive epilepsy may occur by the diverse new implements. We experienced three patients suffered from the first seizure while using photosonic devices. The device is composed of light stimulating goggles and sound producing headphones. CASE: All the patients were teen-aged school girls and the types of seizure were generalized tonic-clonic seizure, focal motor seizure with secondary generalization, and complex partial seizure. They lost their consciousness while using the devices with the red colored light. Events began without aura in two but one patient felt continuous red flash light until after taking off the device. EEG revealed right frontal dominant spike-wave complexes in one but other patients showed no epileptiform discharges. During a year follow-up the patient who showed EEG abnormalities experienced another seizure that was focal motor seizure with secondary generalization but remained two did not. COMMENTS: Though the video game epilepsy is regarded as a kind of photosensitive epilepsy, the emotional excitement may contribute to the occurrence of seizure. But, this photosonic device is used for relaxation and our three patients showed normal EEG while photic stimulation during the tracing. We suggest that seizure induced by the photosonic lev genuine type of photosensitive epilepsy.

Variables Associated with Delayed Hospital Arrival of Stroke Patients Living in Taejon and Its Suburban Areas

Recent stroke researches have re-emphasized the critical therapeutic time window for antithrombotic and neuroprotective trials for the stroke victims. In this prospective study , we tried to reveal the variables that had delayed the presentation time of the acute stroke patients living in Taejon and its suburban areas. The time of stroke onset, distance from the place of stroke occurrence to the Chung-nam National Univorsity Hospital (CNUH), level of consciousness, basic demographic data, place of residence, and referral routes were assessed. During the study period of 8 months, 173 new patients visited the emergency department of the CNLTH.in the acute phase of stroke. Of 173 patients, 122 had cerebral ischemia (CI), 40 intracerebral hemorrhage (ICH), and 11 subarachnoid hemorrhage (SAH). Only 91 patients (52.6%) presented within 6 hours. Fourty-six percent of Cl, 65% of ICH, and 72% of SAH patients presented within 6 hours. There was no correlation between the presentation time and the age, sex, stoke subtype, distance from CNLTH, and place of residence. The vat-la ' bles that had significantly delayed the presentation time included the better initial consciousness level and referral route through the oriental medicine clinics. These findings suggest that the need for prompt management of stroke patient is poorly understood and that the onental medicine is still preferred by the general population. Tlius, we need to develop an education program and public activities as well as an effective patient dehvery system to nunmum the neuronal damage following stroke.