Patient case (clinical description): A 47-year-old woman comes to the clinic complaining of dizziness.  She also has occasional nausea and ringing in her right ear.  The patient also has difficulty hearing while holding her phone to the left ear, although hearing in her right ear is normal.  The dizziness improves spontaneously, and she feels fine between episodes.  Past medical history is notable for hypothyroidism and low vit D level, for which she is using Levothyroxine and Vit D pearl.  She does not use tobacco or drink alcohol. Physical examination shows sensorineural hearing loss in the left ear. She has only one-man sexual partner and menopaused 2 years ago.

Patient's own account: The other day, I had to go to the clinic due to severe dizziness. I'm 47 years old, and I've been suffering from nausea and ringing in my right ear. I also have difficulty hearing in my left ear while I hold my phone, even if my hearing in my right ear is normal. The dizziness just gets me all of a sudden but I don't have any symptoms in between 2 episodes. I suffer from hypothyroidism and low vitamin D levels. So I take Levothyrox and vitamin D pearl. I don't smoke or drink. They conducted a physical exam and said I had hearing loss in my left ear. My only partner is my husband, and I'm menopause for 2 years now.

Clinical trial: Effect of rTMS on Resting State Brain Activity in Tinnitus

Eligibility criteria:
Inclusion Criteria per protocol and informed consent:

          -  Diagnosis of tinnitus established through a history and physical exam or review of
             records.

          -  Subjects 19-89 years of age

          -  Tinnitus present for at least 6 months and severe enough to seek medical attention

          -  Subjects taking SSRI's (a class of anti-depressant medications)and benzodiazepines (a
             class of anti-anxiety medications) for depression or anxiety related to tinnitus must
             be stable on their current dose for at least 3 months and must not alter their dose or
             medication during their involvement with this study

          -  Subjects must agree to avoid consuming alcohol within 72 hours of each rTMS session

          -  Female subjects of childbearing potential must demonstrate a negative pregnancy test
             during their initial clinic visit and must agree to use effective contraception during
             their participation in this study

          -  Subjects must sign an informed consent and agree to comply with study and follow-up
             procedures, including completion of all necessary questionnaires and testing, as well
             as, being video-recorded for safety purposes during rTMS sessions

          -  Subjects must speak and comprehend English adequately to understand and complete any
             study-related instructions and questionnaires

        Exclusion Criteria per protocol and informed consent:

        For rTMS

          -  Subjects or any of their 1st-degree relatives must not have been diagnosed with
             epilepsy

          -  Subjects must not have a history of seizure disorder or migraines

          -  Subjects must not have any history of a brain aneurysm, stroke, previous cranial
             neurosurgery, acoustic neuroma, glomus tumor, active Menniere's Disease, profound
             hearing loss (greater than 90 dB at 4000 Hz), or any major neurological or psychiatric
             disorders (excluding depression or anxiety related to tinnitus)

          -  Medications that lower seizure threshold or reduce cortical excitation (i.e.,
             tricyclic antidepressants, bupropion or anticonvulsants)

          -  Subjects must not have any history of a head injury that resulted in a loss of
             consciousness for more than 10 minutes

          -  Subjects must not be pregnant or refuse to utilize effective contraception during
             their participation in this study For MRI

          -  Subjects must not have any metal implants or devices in the head or neck or a
             pacemaker.

          -  Subjects must not have severe claustrophobia if they are to have an MRI.

          -  Significant abnormalities must not be present on acquired or existing CT or MRI image
             of the head.
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 19 Years old.
Subject must be at most 89 Years

Eligibility (NLI label): Entailment