Somatosensory pulsatile tinnitus syndrome: somatic testing identifies a pulsatile tinnitus subtype that implicates the somatosensory system.

A new tinnitus syndrome is described: high-pitched, cardiac-synchronous tinnitus, whose pulsations are suppressed by strong contractions or compressions of the neck and jaw muscles (somatic testing). 14 cases, 6 non-lateralized and 8 unilateral, are reported. In the non-lateralized cases, onset was bilateral. In the one intermittent case, while her tinnitus was absent her pulsatile tinnitus could be induced by somatic testing. No etiology was found from physical examination, imaging, or ancillary testing. Because these cases of pulsatile tinnitus can be both induced and suppressed by activation of the somatosensory system of the head or upper lateral neck, we propose that this syndrome is occurring from (a) cardiac synchronous somatosensory activation of the central auditory pathway or (b) failure of the somatosensory-auditory central nervous system interactions to suppress cardiac somatosounds.