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Ask DrDon Your Own Question
DrDon, Board Certified Physician
Category: Neurology
Satisfied Customers: 7
Experience:  Thirty-three years Full-Time ER Practice; Multiple Awards for Contribution to Medical Care
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You previously answered a question about a sizzling noise in

Customer Question

You previously answered a question about a sizzling noise in my head as I am tapering off diazepam. This noise is getting worse as I reduce the dose and today my head feels pressurised as well. Do you expect the volume to keep increasing as the dose reduces as I am not sure that I can stand it if that is the case? What could be causing it? I have also got a symptom of Depersonalization do you think that this might be connected to this noise. It is as if the various parts of the brain aren't connecting properly.
Submitted: 5 years ago.
Category: Neurology
Expert:  DrRussMd replied 5 years ago.
I have reviewed your question
Has an ENT doctor reviewed your ears recently?
Customer: replied 5 years ago.

No. The tinnitus developed during the tapering of diazepam and it is a common withdrawal symptom. I have not experienced any hearing loss. The noise has now moved from my ears to more within the top of my head.

This question was directed at Dr Bob who previously dealt with me.

Expert:  DrRussMd replied 5 years ago.
OK I will opt out
Customer: replied 5 years ago.
how does this now get to Dr Bob?
Customer: replied 5 years ago.
Relist: Other.
No answer was given as the expert decided to opt out
Expert:  DrDon replied 5 years ago.
I'm not Dr. Bob, but thought I would try to help, if you wish. A few questions in case you do:
1. What is the altitude where you live?
2. What kind of workup have you had for your problems? (Cat Scans, MRI's, other)
3. Is the sizzling noise, when you experience it, constant or pulsating (that means is it steady or does it go woosh, woosh, woosh)?
Let me know these, and we can see if I can help.
Dr. Don
Customer: replied 5 years ago.

1) Altitude is approx 500 feet above sealevel

2) No intensive work up, had a Brain MRI before this started which was clear. The noise started mid way through a taper off Diazepam (currently 75% complete) and as it is a common withdrawal symptom I assumed that was what it was.

3) The noise is pretty constant sometimes sizzling, sometimes woshing, sometimes ticking like a clock and sometimes like air escaping from a tyre. Today it is in the top of my head woshing sort of pulse like. There is always some sort of noise 24/7. If it is going to change, it does so overnight when I am sleeping.

I wonder if it could be connected with anxiety, as I am very anxious about getting of the Benzo, which was prescribed for anxiety in late 2008.

Never had a single noise in my head before all this,

Expert:  DrDon replied 5 years ago.
Do you know if the MRI was with or without contrast?
Customer: replied 5 years ago.
Expert:  DrDon replied 5 years ago.
Okay. Sorry I have not been able to get back to you as quickly as I would have liked. But hopefully, I can help point you into the right direction. It could very well be that your symptoms are caused by medication, anxiety, or withdrawal from the benzodiazapines, as you suggested.

However, it is very important to be sure. Why? Because there are serious situations that can cause symptoms such as you describe, and it is necessary to rule those out thoroughly before coming to a conclusion.
The most concerning disorder to consider is what is called an AV malformation (or AVM). Of course, I am not saying this is what you have, since I cannot know. But it is important to be sure, and do not assume something serious is absent, until verified by the appropriate tests and specialists. Very specific types of MRIs are needed to determine the presence or absence of an AVM. It could be that you have had such a study. In other words, one type of MRI is not necessarily the same as another type of MRI. Please research this on the interet yourself, as well.
What is an AVM? It stands for an arterio-venous malformation. This means that in individuals who have an AVM the arterial and venous sides of the vascular system are connected abnormally. This may occur in only one locations, or in many locations (brain and elsewhere). There is a hereditary form of AVM that affects families.
What would be the symptoms? They can be many, such as dizziness, confusion, memory loss, weakness, anxiety, loss of vision, hallucinations, etc. So, you can see that it is not a minor problem, if it is present.
Why did I think about this possibility in your case? One sign of AVM is what is called a bruit (look this up too). It is a whooshing sound heard as blood passes from an area of higher to lower pressure quickly, and is heard commonly with each heartbeat. Doctors often listen for bruits with a stethoscope. But, if an intracranial (means "in the head") AVM is severe enough, a patient can hear a whoosh-whoosh sound (again, usually with each heartbeat).
Why is it important to see a physician, raise this question, and have it investigated further? Because if an AVM suddenly ruptures or leaks (which can happen), the results can be catastrophic.
What should you do? My suggestion is to see your doctor, or even go to an emergency room. Then, describe this whoosh whoosh sound in detail, and ask for an evaluation to rule out an AVM, as well as a neurology consult. If the tests are completed and negative this time, you can go back to considering the other (less dangerous) causes you mention (such as medications).
Please let me know if you have further questions, or if I can help in any other way.
Best wishes,
Dr. Don