A unilateral tinnitus occurred at right ear in a hypertensive and diabetic woman shortly after an ipsilateral peripheral facial palsy. Audiometric tests showed a predominant sensorineural hearing impairment at right ear. Her tinnitus was abolished after an administration of a low dose of gabapentin. In view of a controversy of gabapentin and tinnitus in previous trials, the fi ndings in this patient support that low dose gabapentin can benefi t specifi cally the subgroup of tinnitus patient with sensorineural impairment due to secondary contributing factor.

Exertional headache is one entity of Valsalva maneuver-related headache syndrome. It is usually idiopathic, but has occasionally been reported to be associated with secondary causes. However, central nervous system infection has not been mentioned before. We encountered a young man who suffered an isolated exertional headache and was found to have an active varicella-zoster virus central nervous system infection without typical intracranial hypertension or outfl ow obstruction. Intracranial vasoconstriction was detected during headache when the patient performed acute lifting or heavy exertion. The fi ndings in this patient suggest a specifi c relationship between varicella-zoster virus-related vasculopathy and exertional headache from other Valsalva maneuver-related headache syndrome