Musical Ear Syndrome
March 20, 2021
Woman listening gossip
Musical Ear Syndrome, MES, which is commonly known as auditory hallucination, is the hearing or perception of music when there is no external source of music.

This is a form of tinnitus.

Tinnitus is the perception of sound in the ears when there is no external source of the noise. Unlike musical ear syndrome, where what is being heard is music or an actual melody, tinnitus noise is more disorganized. Tinnitus noise can be heard as a clicking, ringing, hissing, humming, chirping, buzzing, whistling, whooshing, roaring, and clicking sound.

The perception of the musical sound for people with musical ear syndrome varies from person to person. Some may sound like a group of instruments is playing an entire musical tune, but it may be one instrument playing a single melody for others. Some even hear a voice singing; the voice may be with or without accompaniment.

The most common melodies heard by people with musical ear syndrome are hymns, patriotic music, and Christmas carols.

Due to the nature of musical ear syndrome, many people have mistaken it to be a psychological problem or a symptom of dementia, but this is not so.

Musical Ear Syndrome is a hearing-related problem, but unfortunately, the actual cause can't be determined.

Musical Ear Syndrome is common in older people, but it can affect anyone who has one form of hearing loss or the other.

This syndrome is not the same as when you can't get a song out of your head. Musical Ear Syndrome is different. When you can't get a song out of your head, you are certain that the song is in your head, not from an external source. But it is not the same for people with musical ear syndrome, the melody they hear sounds like it is from a specific and obvious external direction.

This may cause them to seek out the external source of the noise. This is why some people believe it is a psychological problem. Because the person is seeking the source of a sound that no one else around can hear.

Causes of Musical Ear Syndrome

African american businessman wearing suit listening to music while going to work by train

 

Although the actual cause of musical ear syndrome is unknown, there is a possible explanation of why it happens. The most likely cause of musical ear syndrome is auditory deprivation.

If you don't have hearing loss, what you hear as sound, is the product of a combination of sound input from the ear, interpretations by the brain, and predictions by the brain. When there is constant sound input, the brain doesn't need to predict much.

However, if there is hearing loss, sound input is either reduced or absent depending on the degree.

In the absence of sound input, your brain is forced to do more predicting to interpret the sound input received.

The severity of the hearing loss determines the severity of the loss of input or auditory deprivation. This increases the need for your brain to fill the gap.

The auditory deprivation causes the auditory cortex to become hypersensitive. This triggers the brain to generate sound by itself to fill up the void created by the absence of sound input. In simple terms, musical ear syndrome can result from your brain filling the blanks caused by a lack of external sound.

This void is filled with random noise for people with tinnitus, but for people with musical ear syndrome, the brain produces melodious or musical sounds.

Asides from lack of auditory input, other possible causes of musical ear syndrome are;

1. Hearing Loss

As already stated, when there is hearing loss, there is the loss of auditory input. Depending on the cause or the severity, hearing loss can be temporary or permanent, affecting one or both ears.

The absence of auditory input caused by the hearing loss forces the brain to generate its sound.

2. Medications

Certain types of medications can cause different forms of hallucinations, including auditory hallucination or musical ear syndrome.
Certain psychiatric medications like Haldol (haloperidol), Zyprexa (Olanzapine), and Seroquel (quetiapine) have been identified as possible causes of hallucination.

These drugs are not originally intended to cause hallucinations; the hallucinations are usually the side effect it has on the user.

Other examples of drugs that can cause auditory hallucinations are; Ativan (Lorazepam), Ambien( zolpidem), Requip(ropinirole), Lunesta (eszopiclone) sulfa drugs, and cephalosporins.

It is rare for medication to cause musical ear syndrome, but the possibility can't be ruled out if you start experiencing musical ear syndrome right after taking a medication; report to your doctor immediately.

3. Cochlear Implant

Even though extensive studies have not been carried out to back the claims that cochlear implants can cause musical ear syndrome, smaller studies have confirmed it.

These studies have shown that musical ear syndrome can be triggered by cochlear implantation or removal.

While there is not much proof to back this up, if cochlear removal can cause musical ear syndrome, it is probably due to the absence of auditory input. Cochlear implants are given to people with hearing problems to aid their hearing. If this implant is removed, the ear can no longer send auditory input to the brain. This sudden lack of auditory input can force the brain to generate its sound.

Certain conditions like Alzheimer’s, hyperacusis, dementia, and Epilepsy can also trigger or increase the likelihood of musical ear syndrome.

Musical Ear Syndrome Treatment

Plastic surgeon examines ear of patient before plastic surgery

 

There is no specific cure for musical ear syndrome; this is because the exact cause of the syndrome is not yet known. Also, due to the heterogeneity of the symptoms, treatments are often unique to individuals.

This means that because of the varying degree of severity and the varying type of musical sounds heard, two people suffering from musical ear syndrome may not receive the same treatment.

These treatments are not geared towards curing musical ear syndrome because they cannot do that. They are often prescribed to help people to adjust to the sounds and improve the symptoms. Below are certain treatments for musical ear syndrome;

1.Hearing aids

If the musical ear syndrome is caused by hearing loss, hearing aids may be able to get rid of the music in your ears.

A hearing aid is a battery-powered device that is designed to aid or improve hearing. Hearing aids can help amplify sound, or they can improve your hearing in both quiet and noisy places. They are usually worn behind the ear or in the ear canal.

Most people with hearing loss have difficulty hearing or picking sound signals. But with the help of a hearing aid, they will be able to hear.

Here is how; the microphone on the hearing aid picks external sound and sends it to the amplifier. The amplifier increases the volume of the sound; then, the receiver sends the sounds into the ear, where it is then transferred to the brain for interpretation.

Since there is a hearing aid to pick up external sounds, your brain no longer needs to generate sound inputs to fill the blanks.

2. Medications

Even though certain medications can cause auditory hallucinations, some drugs can help relieve the symptoms.
There is no exact medication or one size fit all medication for treating musical ear syndromes.

The drugs below may be successful in treating musical ear syndrome in one person and fail in another person; this is due to the heterogeneous etiology of musical ear syndrome.

Antiepileptics, benzodiazepines, and antipsychotics medications can help to treat musical ear syndrome. Donepezil has also been identified as a possible treatment for musical ear syndrome.

If you developed musical ear tinnitus after using a betamethasone steroid, switching to a prednisolone steroid can make the music in your ears disappear.

Other drugs that may help treat musical ear syndrome are selective serotonin reuptake inhibitors, atypical neuroleptics or atypical antipsychotics, and cholinergic agents.

Just like every other drug, these drugs have certain side effects. It is, therefore, that you only take them on your doctor's prescription and supervision.

3. Cognitive Behavioral Therapy

Cognitive-behavioral therapy (CBT) is a psychotherapeutic or psycho-social intervention or treatment that is aimed at improving mental health.
The therapy helps people learn how to identify and change disturbing thought patterns that negatively affect their emotions and behavior.

While this may not cure musical ear syndrome, it can help you live with it without being adversely affected by its presence. CBT will help you improve your emotional regulation and also help you to develop personal coping strategies that will help you ignore the music in your ears and focus on your daily activities without much interference.

4. Lifestyle Changes

woman in meditation

 

Musical ear syndrome is not the end of a normal life for you. There are a lot of people who have it but are enjoying their lives. A few lifestyle changes may be all you need to go back to the way things were before you started hearing songs in your ear. Below are a few lifestyle changes you might want to consider.

  • Create Background Noise
    This may appear counterproductive, but it is not. Creating a background noise by listening to music or using a white noise machine can keep your brain distracted. When there is enough background noise, your brain won't need to become a choirmaster.
  • Regular Exercise
    Regular exercising keeps you fit and helps you relieve stress. Regularly exercise both outdoor and indoor. You can also try yoga or practice deep breathing, mindfulness, and meditation. Aromatherapy and massage therapy are also good ideas you should try out.
  • Stress Management
    Stress can worsen your musical ear syndrome symptoms; it is, therefore, important to find ways to minimize and relieve stress. Stress can trigger anxiety, and anxiety has been known to both trigger and aggravates noise in the ear.

    The relationship between tinnitus and anxiety is circular, tinnitus causes anxiety, and anxiety worsens tinnitus, and the worsened tinnitus causes more anxiety. To avoid aggravating the noise in your ears, avoid anything or activity that will stress you. Always take out time to relax. This will distract you and take your mind away from the song in your ears.

Conclusion

If you have musical ear syndrome, don't panic, you are not losing your mind; the problem is with your hearing.

Seek professional medical help immediately when you notice a musical noise in your ear. It may be overwhelming and challenging at the initial stage, but with the right medical help and therapy, you will be able to live a normal life.

Do you have musical ear syndrome? What does the music sound like? How are you coping with it? Share your experience with us.

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Drew Sutton M.D.

Drew Sutton, MD is a board-certified otolaryngologist. He has extensive experience and training in sinus and respiratory diseases, ear and skull base surgery, and pulmonary disorders. He has served as a Clinical Instructor at Grady Hospital Emory University for more than 12 years.

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