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Related Experiment Videos

Central hyperacusis with phonophobia in multiple sclerosis.

H Weber1, K Pfadenhauer, M Stöhr

  • 1Department of Neurology and Clinical Neurophysiology, Klinikum Augsburg, Augsburg, Germany. oa.neurologie@klinikum_augsburg.de

Multiple Sclerosis (Houndmills, Basingstoke, England)
|December 12, 2002
PubMed
Summary

Central phonophobia, an underrecognized symptom of multiple sclerosis (MS), involves painful sound sensitivity. Early identification of MS-related auditory pathway lesions is crucial for timely intervention.

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Area of Science:

  • Neuroscience
  • Audiology
  • Neurology

Background:

  • Hearing disorders, including hyperacusis and deafness, are recognized symptoms in multiple sclerosis (MS).
  • These are often linked to demyelinating lesions within the central auditory pathway.
  • Central phonophobia, characterized by painful responses to acoustic stimuli, is less commonly associated with MS.

Observation:

  • Three patients with brainstem syndromes presented with central phonophobia.
  • Standard audiological tests (ENT inspection, audiometry, stapedius reflex) were normal.
  • Pathological auditory evoked potentials (AEPs) and MRI revealed demyelinating lesions in the brainstem and auditory pathways.

Findings:

  • Patient 1 experienced shooting facial pain triggered by sounds, suggesting abnormal impulse conduction.

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  • Patients 2 and 3 reported intensified noise sensations and directional hearing deficits, indicating central sensory modulation disturbances.
  • All patients later developed clinically definite multiple sclerosis.

    • Implications:

    • Central phonophobia, after excluding peripheral causes, should raise suspicion for multiple sclerosis.
    • Identifying demyelinating lesions in the auditory pathway is key for diagnosing MS-related auditory dysfunction.
    • Treatment options may include serotonin reuptake inhibitors or acoustic lenses targeting specific frequencies.