Decreased sound tolerance includes hyperacusis and/or misphobia (phonophobia). As a commonly subjective symptom, tinnitus is defined to be a sound perceived in the ear or head without corresponding sound or electrical stimulus in the surrounding environment. It is usually occurred with or without hearing loss or harmful psychic reaction, which includes dyssomnia, annoy, rage, anxiety, depress, hard to concentrate, etc. Frequently, tinnitus is accompanied by decreased sound tolerance, while this text is aimed to review the correlated concepts of decreased sound tolerance,and focus on the hyperacusis which is a more common symptom.
Humans ; Hyperacusis ; Tinnitus

BACKGROUND AND OBJECTIVES: Hyperacusis, defined as increased sound sensitivity or decreased sound tolerence, has been reported to be related to tinnitus. The purposes of this study are to investigate the audiometrical characterization of hyperacusis and to evaluate the possible effect of hyperacusis on clinical presentation in tinnitus patients. MATERIALS AND METHOD: A total of 128 tinnitus patients, who visited the Tinnitus Clinic, Kangnam St. Mary's Hospital from May, 1999 to September, 2000, were included in this study. Their audiometrical study results were analyzed, and their hearing impairment was compared with those of normal controls. RESULTS: The prevalence of hyperacusis in the patients with tinnitus were as high as 37.8% according to the questionnare. Uncomfortable loudness levels to pure tone stimuli was significantly low in hyperacusis patients. In the tinnitus patients with normal hearing, the tinnitus handicap scores between hyperacusis and non-hyperacusis patients were significantly different, though the results of tinnitogram showed no difference. CONCLUSION: The hyperacusis test using pure tone stimuli may screen hyperacusic patients. It is necessary to consider the presence of hyperacusis in tinnitus patients so as to understand patient discomfort and to seek appropriate treatment modality.
Hearing ; Hearing Loss ; Humans ; Hyperacusis* ; Prevalence ; Tinnitus

Consensus ; Humans ; Hyperacusis ; therapy ; Iowa ; Practice Guidelines as Topic ; Tinnitus ; therapy

Superior semicircular canal dehiscence syndrome (SCDS) is a rare disease caused by dehiscence in the bone overlying superior semicircular canal. Patients with SCDS present vestibular and auditory manifestations including dizziness and hyperacusis. These manifestations can be controlled by surgical repair of the dehiscence such as plugging or resurfacing the defect. We report a case of a 25 year-old man with SCDS who underwent surgical repair of dehiscence through middle fossa approach.
Dizziness ; Humans ; Hyperacusis ; Rare Diseases ; Semicircular Canals ; Vertigo

BACKGROUND: It is well-known that migraineurs frequently have abnormal findings on transcranial Doppler ultra-sound (TCD), but their clinical implications are not clear. We investigated the clinical significance of TCD findings in migraineurs. METHODS: One hundred thirty-seven consecutive migraineurs were prospectively gathered. The following clinical parameters were investigated : 1) age and sex, 2) time from onset of headache to visiting hospital, 3) frequency, duration, laterality, pulsating quality, and severity of headache, 4) presence of nausea, vomiting, photophobia, and phonophobia, 5) aura, and 6) aggravation of headache by routine physical activity. TCD was performed during a headache-free period to measure the mean flow velocities (MFVs) and other parameters of 13 intracranial and 2 extracranial vessels. If MFV of any artery or its side-to-side difference in each migraineur was beyond 2 standard deviations of corresponding age and sex-matched reference subgroups, the TCD result was regarded as abnormal. Correlations between abnormal TCD and clinical parameters were examined by univariate and multivariate analyses. RESULTS: Results of TCD were abnormal in 84 patients (61.3%). Pulsatility of headache and absence of aura were significantly correlated with abnormal TCD on univariate analyses (p=0.003 and 0.049 respectively). On multivariate analysis, pulsatility of headache was the only statistically significant predictor of abnormal TCD (p=0.015). Headache attacks tended to be less frequent in patients with abnormal TCD with marginal significance (p=0.050). CONCLUSIONS: Our study shows that abnormal results on TCD are more frequent in migraineurs with pulsatile headache. An association between abnormal TCD and frequency of headache attacks is suggested.
Arteries ; Epilepsy ; Headache ; Humans ; Hyperacusis ; Migraine Disorders ; Motor Activity ; Multivariate Analysis ; Nausea ; Photophobia ; Prospective Studies ; Vomiting

PURPOSE: Migraine is a common disorder in childhood. Its associated symptoms such as nausea or dizziness etc. are frequently complained about and worsen discomfort in cases of pediatric migraine. This study aimed to investigate the relieving effect of preventive therapy on the associated symptoms as well as headache-related characteristics. METHODS: We reviewed the clinical data of subjects aged seven to eighteen years who were diagnosed with migraine and had received prophylactic medication for more than two months. The headache-related characteristics and associated symptoms were analysed with prophylactic drugs at one month and three months after medication. RESULTS: The gender ratio was 11:10 and the mean age was 10.8 years. One month after medication, the duration of headache was reduced in ten of nineteen, a reduction in frequency was observed in fourteen, and improvement in headache intensity in nine. The duration time was shortened in three of eight subjects three months after initiation of medication, the frequency reduced in five, and decreased intensity in seven. Nausea was absent in eight of fifteen one month after treatment, abdominal pain in seven of thirteen, dizziness in five of sixteen, photophobia in six of seventeen, and phonophobia in seven of sixteen. The ratio of disappearance of associated symptoms increased three months after initiation of treatment. CONCLUSION: Prophylactic medication may be effective in relieving migraine-associated symptoms as well as improving headache-related characteristics.
Abdominal Pain ; Adolescent ; Aged ; Child ; Dizziness ; Headache ; Humans ; Hyperacusis ; Migraine Disorders ; Nausea ; Photophobia

Myasthenia gravis (MG), which is the most common autoimmune neuromuscular junction disorder, is characterized by weakness of musdes and increased fatigability after repetitive use, and recovery after rest. The diagnosis is based on a detailed history, physical examination, and pharmacological, electrophysiological, and immunological testing. Stapedial reflex abnormalities are noted, so the stapedial reflex decay test (SRDT) can be attempted. There are no reports regarding the SRDT in Korea. We report a case of MG presenting hyperacusia and ptosis that was diagnosed by the SRDT. We recommend using the SRDT in the clinical diagnosis of MG.
Hyperacusis ; Immunologic Tests ; Korea ; Myasthenia Gravis ; Neuromuscular Junction Diseases ; Physical Examination ; Reflex

BACKGROUND AND OBJECTIVES: Hyperacusis is an abnormally strong reaction which occurs within auditory pathways resulting from exposure to moderate sound. More patients are inflicted with it than with tinnitus, accounting for a relatively high proportion of the total tinnitus patients. However, no single test could pass as an objective diagnostic test of hyperacusis. Among various psychoacoustic evaluations, loudness discomfort level (LDL) is frequently used in the evaluation of hyperacusis. Thus, this study aimed to demonstrate a proportion of hyperacusis in tinnitus patients and characterize LDL in hyperacusis and tinnitus patients as a diagnostic test. MATERIALS AND METHOD: Using 186 patients with tinnitus as experiment group and 35 acoustically normal persons as control group, pure tone audiometry (PTA), LDL, and dynamic range (DR) were checked. RESULTS: Amongst the total number of tinnitus patients, there were 10 hyperacusis patients (5.38%). Those hyperacusis patients had much lower LDL (73.50 dB) and DR (41.50 dB) than tinnitus patients without hyperacusis (LDL: 100.90 dB, DR: 67.20 dB) as well as the control group (LDL: 104.86 dB, DR: 93.98 dB). CONCLUSION: Hyperacusis patients consist 5.38% (10/186) and have much lower LDL than tinnitus patients without hyperacusis and the control group. There is a positive correlation between hyperacusis and LDL. Therefore, in a diagnosis of hyperacusis, it is essential to check LDL and take a careful look into the history from patients.
Audiometry ; Auditory Pathways ; Diagnosis ; Diagnostic Tests, Routine ; Humans ; Hyperacusis* ; Psychoacoustics ; Tinnitus*

BACKGROUND AND OBJECTIVES: We aimed to evaluate associated symptoms in patients with Bell's palsy and prognosis according to associated symptoms. SUBJECTS AND METHOD: Seventy-four patients with Bell's palsy were enrolled in this study. We evaluated the degree of facial palsy with Facial Nerve Grading System 2.0. The grade of facial palsy was determined as initial facial palsy at admission and as final facial palsy at visit after 3 months. Afterwards, we examined symptoms (such as otalgia, facial numbness, taste disturbance, eye problems, hyperacusis, and tinnitus) and co-morbid diseases (such as diabetes mellitus and hypertension) associated with facial palsy. After 3 months of the onset of facial palsy, we examined the changes in the associated symptoms. RESULTS: At admission, 71.6 percent of all patients had symptoms associated with facial palsy. Of the associated symptoms, facial numbness and taste disturbance were the most common, which were still found in 23% of the patients after 3 months of the onset of facial palsy. Patients with a high initial grade of facial palsy were accompanied by taste disturbance and hyperacusis more than by other symptoms. Also patients who had auricular pain during the recovery period of Bell's palsy showed poor prognosis. Compared to non-hypertension patients, for patients with hypertension, taste disturbance was more common during the early period whereas eye problems were more common during the recovery period. CONCLUSION: Patients with Bell's palsy had diverse symptoms associated with facial palsy. During the early period of Bell's palsy, we concluded that there was no correlation between the symptoms and the prognosis. However, patients with pain around the ear during the recovery period showed poor recovery of facial palsy.
Bell Palsy ; Diabetes Mellitus ; Ear ; Earache ; Eye ; Facial Nerve ; Facial Paralysis ; Humans ; Hyperacusis ; Hypertension ; Hypesthesia ; Prognosis

Lots of neuroimaging and animal studies have revealed that tinnitus and hyperacusis share the same patterns in the bottom up central auditory process. The aim was to identify the abnormal central patterns commonly observed in both tinnitus and hyperacusis in humans. We investigated two cases of normal hearing: a tinnitus patient and a hyperacusis patient. We compared the differences between the severe temporal hyper-activated state (STHS), with spikes, fast beta and gamma frequencies after noise exposure, and the mild temporal hyper-activated state (MTHS), in no sound exposed condition. The power of the gamma band in the two cases was increased in both auditory cortices compared to the other brain regions. Our results of human with normal hearing were the first to identify how tinnitus and hyperacusis caused by sound are abnormally active and how they maintain constant pathological states.
Animals ; Auditory Cortex ; Brain ; Electroencephalography ; Hearing ; Humans ; Hyperacusis ; Neuroimaging ; Noise ; Tinnitus