Comprehensive Protocol for Pulsatile Tinnitus and Cranial Assessment

Definition of Pulsatile Tinnitus: This specific condition is characterized by patients hearing a "whooshing" sound that synchronizes with the pumping of their blood.
Initial Assessment Strategy: Paul emphasizes that addressing these symptoms requires a "very very comprehensive" approach involving long-tail analysis and several hours of dedicated assessment to identify the root cause.
Medical History Review: A critical first step is a thorough investigation of the patient's past medical history to identify overlooked traumas. Specific focus should be placed on:
- Minor closed head injuries.
- Major closed head injuries.

Cranial Therapy: Patients should be assessed by a skilled cranial therapist or a cranial sacral therapist.
- Mechanism of Dysfunction: Cranial sutures can become "locked down" due to fascial restrictions.
- Symptomatic Fallout: This restriction disrupts the vestibular system and can manifest as vertigo or other balance-related issues.
Pathology of Tinnitus: Tinnitus is fundamentally considered a degenerative disease of the $\text{8th}$ cranial nerve. While many theories exist, Paul notes that improvement is possible even when conventional doctors suggest otherwise.
The Atlas (C1): Ensuring the proper function of the Atlas is essential after assessing cranial structures.
- Qualified Practitioners: Assessment should be performed by a skilled physiotherapist, chiropractor, osteopath, or a Czech level three or four practitioner.
- Specialized Training: Paul asserts that the techniques taught to Czech level three practitioners are significantly more technical and accurate than those used in the general rehabilitation community.

Hydration Requirements: Dehydration is a known factor linked to auditory and vestibular problems.
- The Formula for Daily Intake: A person must consume a volume of water equal to half their body weight in ounces per day.
- Calculation: $\text{Daily Water (oz)} = \frac{\text{Body Weight (lbs)}}{2}$ .
Dietary Toxicity and Intolerance: Strange medical symptoms are often the result of food-based chemicals and intolerances.
- The Role of Aspartame: Paul highlights aspartame as a primary culprit for symptoms that "make no sense medically," including:
  - Flashing lights in the eyes.
  - Ringing in the ears.
  - Tachycardia (abnormally fast heart rate).
  - Bradycardia (abnormally slow heart rate).
  - Angina pectoris (chest pain).
Clinical Ecology: For further study on how food reactions impact the human body, Paul recommends the book Clinical Ecology by Lawrence Dickey.
- The book posits that nearly every symptom a human can experience may be categorized as a reaction to food or environmental toxins.

Nerve Entrapments: Physical entrapment of cranial nerves can lead directly to pulsatile tinnitus and related sounds.
Malocclusion and Dental Alignment: When a patient's teeth do not fit together properly (malocclusion), it can prevent the cranial sutures from moving correctly.
- Consequence: This leads to the compression of cranial bones. Areas that previously functioned well begin to break down under this mechanical stress.
The Czech Practitioner Hierarchy:
- Begin with basic lifestyle and structural adjustments.
- If no improvement is observed, seek out a Czech level four practitioner for a high-level assessment and intervention plan.

Question from Magnus: "Hi Paul, do you have any tips on how to cure or remedy pulsatile tinnitus where people hear the whooshing sound of their blood pumping?"
Paul's Response: Paul detailed a multi-step protocol starting with a comprehensive medical history (checking for head injuries), followed by cranial sacral therapy to release fascial restrictions, checking the Atlas function, ensuring hydration ( $\frac{1}{2}$ body weight in ounces), and eliminating dietary toxins like aspartame. He also suggested looking into Clinical Ecology by Lawrence Dickey and checking for malocclusion before seeking advanced help from a Czech level four practitioner.