Musical Ear Syndrome, or MES, more commonly known as auditory hallucination, is the experience of hearing or perceiving music when no external sound source exists. It is a form of tinnitus. Tinnitus is the perception of sound in the ears in the absence of any external source. Unlike Musical Ear Syndrome, where what is heard is music or a real melody, the sound of tinnitus is much more disorganized. It can take the form of clicks, whistles, hisses, hums, chirps, buzzing, rushing, or rumbling. The perception of musical sound varies from person to person in those with Musical Ear Syndrome. Some feel as if they are hearing an entire orchestra playing a complete piece, while others hear only a single instrument playing a unique melody. Some even hear a singing voice, with or without accompaniment. The most frequently heard melodies by people with Musical Ear Syndrome are hymns, patriotic music, and Christmas carols. Due to the nature of this syndrome, many people have mistakenly taken it for a psychological disorder or a symptom of dementia, but this is not the case. Musical Ear Syndrome is a hearing-related problem, but its exact cause unfortunately cannot be determined. It is common in older people, but it can affect anyone with some form of hearing loss. This syndrome has nothing to do with having a song stuck in your head. Musical Ear Syndrome is different. When a song is stuck in your head, you know for sure that it is in your head and not coming from an external source. This is not the case for people with Musical Ear Syndrome: the melody they hear seems to come from a specific and obvious external direction. This can lead them to search for the source of the sound. This is why some believe it is a psychological disorder: the person is looking for the origin of a sound that no one else around them can hear.
Causes of Musical Ear Syndrome
Even though the actual cause of Musical Ear Syndrome remains unknown, there is a plausible explanation for its occurrence. The most probable cause is auditory deprivation. If you don't have hearing loss, what you perceive as sound is the product of a combination of sound information captured by the ear, its interpretation by the brain, and the predictions the brain makes. When sound information arrives continuously, the brain doesn't need to predict much. However, in cases of hearing loss, sound information is reduced or even absent, depending on the degree of impairment.
In the absence of sound information, your brain is forced to predict more to interpret the little it receives.
The severity of hearing loss determines the extent of information loss, in other words, auditory deprivation. The greater it is, the more your brain has to fill in the gaps. This auditory deprivation makes the auditory cortex hypersensitive. The brain is then prompted to generate sounds itself to fill the void left by the absence of sound input. Simply put, Musical Ear Syndrome can result from your brain filling in the blanks created by the lack of external sounds. In people with tinnitus, this void is filled with random noises; in people with Musical Ear Syndrome, the brain produces melodious or musical sounds. In addition to the lack of auditory information, other possible causes of Musical Ear Syndrome include:
1. Hearing loss
As we have already said, hearing loss leads to a loss of auditory information. Depending on its cause or severity, hearing loss can be temporary or permanent and affect one or both ears.
The absence of auditory information caused by hearing loss forces the brain to generate its own sounds.
2. Medications
Certain types of medications can cause different forms of hallucinations, including auditory hallucinations or Musical Ear Syndrome. Some psychiatric medications such as Haldol (haloperidol), Zyprexa (olanzapine), and Seroquel (quetiapine) have been identified as possible causes of hallucinations. These medications are obviously not intended to cause hallucinations: these are usually a side effect in the user. Other medications that may cause auditory hallucinations include Ativan (lorazepam), Ambien (zolpidem), Requip (ropinirole), Lunesta (eszopiclone), sulfonamides, and cephalosporins. It is rare for a medication to cause Musical Ear Syndrome, but this possibility cannot be ruled out: if symptoms appear just after starting treatment, report it immediately to your doctor.
3. Cochlear implant
Although no large-scale studies have been conducted to confirm that cochlear implants can cause Musical Ear Syndrome, smaller studies have established this.
This work has shown that Musical Ear Syndrome can be triggered by the insertion or removal of a cochlear implant. Evidence remains limited, but if the removal of a cochlear implant can cause this syndrome, it is probably due to the absence of auditory information. Cochlear implants are placed in people with hearing impairments to help them hear. If the implant is removed, the ear can no longer transmit auditory information to the brain. This sudden disappearance can force the brain to generate its own sounds. Certain conditions such as Alzheimer's disease, hyperacusis, dementia, and epilepsy can also trigger Musical Ear Syndrome or increase its likelihood.
Treatment of Musical Ear Syndrome
There is no specific treatment for Musical Ear Syndrome, precisely because its exact cause remains unknown. Furthermore, due to the heterogeneity of symptoms, treatments are often specific to each individual. In other words, due to varying degrees of severity and different types of perceived musical sounds, two people suffering from Musical Ear Syndrome will not necessarily receive the same treatment. These treatments are not intended to cure the syndrome, as they are unable to do so. They are generally prescribed to help patients adapt to the sounds and alleviate symptoms. Here are some treatments for Musical Ear Syndrome:
1. Hearing aids
If Musical Ear Syndrome is due to hearing loss, hearing aids may be able to make the music in your ears disappear. A hearing aid is a battery-powered device designed to facilitate or improve hearing. Hearing aids can amplify sound or improve your hearing in quiet and noisy environments. They are generally worn behind the ear or in the ear canal. Most people with hearing loss have difficulty hearing or picking up sound signals. But with a hearing aid, they can. Here's how: the hearing aid's microphone picks up external sound and sends it to the amplifier. The amplifier increases the volume of the sound, and then the speaker transmits it to the ear, from where it is sent to the brain for interpretation. Since a hearing aid now picks up external sounds, your brain no longer needs to generate sounds to fill in the blanks.
2. Medications
Although some medications can cause auditory hallucinations, others can help alleviate symptoms. There is no single medication or universal solution for treating Musical Ear Syndrome. The medications below may be effective in one person and ineffective in another, due to the heterogeneous origin of the syndrome. Antiepileptics, benzodiazepines, and antipsychotics can help treat Musical Ear Syndrome. Donepezil has also been identified as a possible treatment. If your musical tinnitus appeared after taking a betamethasone-based corticosteroid, switching to a prednisolone-based corticosteroid may make the music in your ears disappear. Other medications that may help include selective serotonin reuptake inhibitors, neuroleptics or atypical antipsychotics, and cholinergic agents. Like any medication, these have side effects. It is therefore essential to take them only under prescription and under the supervision of your doctor.
3. Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is a psychotherapeutic or psychosocial intervention aimed at improving mental health. It helps people identify and modify disruptive thought patterns that negatively affect their emotions and behavior. While it does not cure Musical Ear Syndrome, it can help you live with it without experiencing its detrimental effects. CBT will help you better regulate your emotions and develop personal coping strategies that will allow you to ignore the music in your ears and focus on your daily activities without too much interference.
4. Lifestyle changes
Musical Ear Syndrome does not mean the end of a normal life. Many people suffer from it while fully enjoying their lives. A few lifestyle changes may be enough to return to the situation you were in before hearing songs in your ears. Here are some avenues to consider.
Create background noise. This may seem counterproductive, but it is not. Creating background noise by listening to music or using a white noise generator helps distract your brain. When there is enough background noise, your brain no longer needs to play choir leader.
Exercise regularly. Regular physical activity keeps you fit and helps you relieve stress. Move regularly, both indoors and outdoors. You can also try yoga or practice deep breathing, mindfulness, and meditation. Aromatherapy and massages are also good ideas to explore.
Manage your stress. Stress can worsen the symptoms of Musical Ear Syndrome: it is therefore important to find ways to limit and relieve it. Stress can trigger anxiety, and anxiety is known to both cause and worsen ear noises. The relationship between tinnitus and anxiety is circular: tinnitus causes anxiety, anxiety worsens tinnitus, and worsened tinnitus generates even more anxiety. To avoid amplifying the noise in your ears, avoid anything that stresses you. Always take time to relax. This will distract you and take your mind off the song in your ears.
Conclusion
If you suffer from Musical Ear Syndrome, don't panic: you're not losing your mind, the problem is with your hearing.
Consult a healthcare professional quickly as soon as you notice a musical sound in your ear. This can be unsettling and challenging at first, but with appropriate medical and therapeutic support, you can lead a normal life. Do you suffer from Musical Ear Syndrome? What does the music you hear sound like? How do you live with it? Share your experience with us at CLARIA.
