The most common cause for hyperacusis is noise exposure either from an acoustic incident or a history of high level sound exposure. Musicians, for example, show a higher prevalence of hyperacusis than the general population. Suspected mechanisms behind noise-induced hyperacusis are discussed later in Potential Mechanisms.
Hyperacusis is more generally a symptom that may arise in several clinical conditions. The mechanisms of hyperacusis for these conditions can be different and are sometimes poorly understood. For example, with Bell’s palsy, hyperacusis may occur because the stapedius muscle can no longer contract to protect the ear. In the case of superior canal dehiscence, conductive hyperacusis in the cochlea is suspected. With autism, neurological mechanisms are suspected. Below is a list of conditions that potentially include hyperacusis as a symptom (Pienkowski, Tyler et al. 2014). Some conditions are treatable and ought to be reviewed as part of a preliminary medical evaluation:
|Otologic||Bell’s Palsy, Ramsay Hunt syndrome, Ménière’s disease, perilymph fistula, superior semicircular canal dehiscence, acoustic trauma, barotrauma, noise-induced hearing loss, stapedectomy, tympanoplasty|
|Neurologic||Autism, carotid aneurysm, middle cerebral aneurysm, migrainous cerebral infarction, head injury, Chiari’s malformation, sympathetic reflex dystrophy, multiple sclerosis, migraine, epilepsy, myasthenia gravis,
cerebrospinal hypertonia, primary thalamo deficiency, attention-deficit disorder, anxiety and depression disorders, posttraumatic stress disorder, complication of spinal anesthesia
|Endocrine||Addison’s disease, pan-hypopituitarism, hyperthyroidism|
|Infection||Neurosyphilis, Lyme disease, typhoid fever|
|Medication||Benzodiazepine and antidepressant withdrawal, acute phenytoin intoxication|
|Deficiency||Magnesium and pyridoxine|
|Genetic or congenital||Williams syndrome, idiopathic hypercalcemy (Fanconi and Williams–Beuren syndrome), Cri du Chat syndrome, Tay–Sachs disease, Cogan syndrome, GM1 gangliosidosis, spina bifida|
|Other||Temporomandibular disorders, fibromyalgia|
Table from A Review of Hyperacusis and Future Directions: Part II., Pienkowski M, Tyler R et. al.
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Pienkowski M, Tyler R et. al. A Review of Hyperacusis and Future Directions: Part II. Measurement, Mechanisms, and Treatment. American Journal of Audiology 2014:23:420-436.