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Carbamazepine responsive typewriter tinnitus from basilar invagination
  1. Eui-Cheol Nam1,
  2. Ophir Handzel2,
  3. Robert A Levine3,4
  1. 1Department of Otolaryngology, College of Medicine, Kangwon National University, Chunchon, Korea
  2. 2Department of Otolaryngology/Head and Neck Surgery, Sourasky Medical Center, University of Tel-Aviv, Tel-Aviv, Israel
  3. 3Eaton-Peabody Laboratory, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
  4. 4Department of Neurology, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Robert Aaron Levine, Massachusetts Eye & Ear Infirmary, 243 Charles Street, Boston, MA 02114-3096, USA; robert_levine{at}


Basilar invagination due to a congenital skeletal disorder kinked the brainstem at the ponto-medullary junction causing both auditory nerves to make an acute turn at the porus acousticus. The associated bilateral asynchronous clicking tinnitus responded to carbamazepine.

  • Tinnitus
  • clicking
  • tinnitus of vascular origin
  • vestibulocochlear nerve diseases
  • trigeminal neuralgia
  • hemifacial spasm

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  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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