Musical ear syndrome : Its causes and treatment


Musical ear syndrome (MES) describes a condition seen in people who have hearing loss and subsequently develop auditory hallucinations. "MES" has also been associated with musical hallucinations, which is a complex form of auditory hallucinations where an individual may experience music or sounds that are heard without an external source. It is comparable to Charles Bonnet syndrome (visual hallucinations in visually impaired people) and some have suggested this phenomenon could be included under this diagnosis


It is postulated that by the "release phenomenon" MES is caused by hypersensitivity in the auditory cortex caused by sensory deprivation, secondary to their hearing loss. This "hole" in the hearing range is "plugged" by the brain confabulating a piece of information – in this case a piece of music. A similar occurrence is seen with strokes of the visual cortex where a visual field defect occurs and the brain confabulates a piece of visual data to fill the spot. This is described by sufferers as an image in the visual field.

The hallucinations are usually not unpleasant but may cause irritation due to their persistent nature. It is common for sufferers to have a history of tinnitus.

Investigations such as magnetic resonanceimaging or CTscanning and electroencephalograms (EEGs) may be worthwhile, but will rarely show any serious pathology.


Given the unknown nature of MES, treatments have been largely dependent on an individual basis. Treatments can vary from being as little as self-reassurance to pharmaceutical medications.

Medications can be helpful, such as antipsychotics, benzodiazepines or antiepileptic, but there is very limited evidence for this. Some case studies have found that switching to a prednisolone steroid after a betamethasone steroid which caused MES helped alleviate hallucinations or the use of the acetylcholinesterase inhibitor, Donepezil, have also found that it successfully treated an individual's MES.However, because of the heterogeneous etiology, these methods cannot be applied as general treatment.

Other than treatment by medicinal means, individuals have also successfully alleviated musical hallucinations by cochlear implants, listening to different songs