Expert: JM Starkman, MD - 11/24/2009

Question
QUESTION: hi I had an epidural blood patch fowling a spinal tap and when the anesthesiologists was done she asked if my ears were ringing i said yes.  i had some fogginess in the head and light headed too.  Two weeks later and it hasn't got better.  why did she ask if my ears were ringing and what is causing it.  Will it go away?  Help.
thank you, Tyrone


ANSWER: Spinal taps resulting in the loss of too much spinal fluid cause the brain to get pulled downward a small amount which pulls on the delicate nerves surrounding it.  This causes a headache and a bloodpatch is recommended to alleviate this as early as possible.  The pulling of nerves can extend to the vestibulocochlear nerve which controls hearing and may result in its dysfunction--hence the ringing called "tinnitus".  It eventually goes away.  Hydration--drinking lots of fluid--is the key to getting over this.  Since it's already been two weeks since your blood patch, I think it's time to ask for an urgent appt with the anesthesiologist who did the
blood patch to re-evaluate you and make sure you do not have a persistent spinal fluid leak at the site of the spinal tap.

Here's a reference article for you to read in the meantime:  British Journal of Anaesthesia, 2003, Vol. 91, No. 5 762-763


---------- FOLLOW-UP ----------

QUESTION: hi again,  I talked to the  anesthesiologist to day about this she said the ringing in my ears is from what you said but i still get light headed and feel a little sick and i have a little of the same headache when im not laying down.  the anesthesiologist said there is nothing we can do.  they said its a MS thing but i didnt have any of this tell I had the spinal tap.  It doesn't add up.  it seems to be geting worse.  help what should i do know?  thanks Tyrone

Answer
The doctor who caused the problem by doing a spinal tap in the first place is responsible for "cleaning up his own mess". Show him or her the BJA article and let him know the anesthesiologist to which he referred you is not helping you.  He can decide which of many avenues to pursue to resolve this.

Good luck.