Auditory Hallucinations

Posted by HearUSA on December 29, 2010 under Hearing Loss | Be the First to Comment

I worked with a patient a few years ago that asked me on her follow-up appointment if the Siemens Music hearing aid was named Music because it played music in her head.  She told me that when the doors opened at her grocery store she heard loud, clear choir music.  She would hear the same song for hours on end.  She was not experiencing hallucinations related to a psychiatric illness.  The ‘music’ she was hearing was an Auditory Hallucination related to her severe sensorineural hearing loss.

Auditory Hallucinations (AH) are defined as perceptions that lack an external stimulus.  They are perceived as sound, and are not under any voluntary control.  AH are typically associated with psychiatric illness; however, they are also reported in hearing impaired patients with no psychiatric symptoms.  While some may consider AH to be a form of tinnitus, they are differentiated from tinnitus by the type of sound perceived and the source.  Tinnitus is often reported as a humming, clicking, frying or tonal-type sound, while AH tend to be complex signals like music or speech. Tinnitus tends to result as damage to the inner ear, while AH are assumed to be generated in the central nervous system.

The sudden onset of music playing in one’s head is frightening, and leads to a heightened emotional state.  Your patient may come to you upset and convinced that the hearing aid is playing the music they are hearing.  The musical hallucinations are most common among elderly women with moderate to severe hearing loss. They are possibly related to auditory deprivation and have been observed following a stroke. Certain medications can also trigger AH.  Tension, anxiety and stress seem to make AH more common and more intense.

Treatment for AH is typically focused on ameliorating the underlying cause. In many cases the cause can not be identified and behavioral, acoustic, pharmacological and Transcranial Magnetic Stimulation (TMS) therapies are utilized.  Our role in helping patients with AH is to counsel them, assist with the diagnosis through audiological testing, and refer them for medical/neurological consultation.

For a thorough review of the nature and treatment of Auditory Hallucinations, see the Sept 2007 Hearing Journal article by Frank Musiek, et. al, “Auditory Hallucinations: An audiological perspective”.