Idiopathic Musical Ear Syndrome in a Young Adult: A Case Report and Therapeutic Response

Musical ear syndrome (MES), or musical hallucinations, is a rare auditory phenomenon involving the perception of music in the absence of external stimuli. This case report presents an idiopathic occurrence of MES in a young female with normal hearing, highlighting the potential efficacy of structured auditory therapy in reducing symptom distress.

A 19-year-old female reported vivid, complex musical hallucinations persisting for 2 years, without any psychiatric, neurological, or audiological abnormalities. Comprehensive audiological and neuropsychological assessments were conducted, including pure-tone audiometry, tympanometry, otoacoustic emissions, imaging, and standardized questionnaires (Tinnitus Handicap Inventory [THI]). A 12-session intervention involving psychoeducation, sound enrichment, and auditory retraining using patient-selected stimuli was implemented.

Audiological and neurological evaluations were normal. The patient demonstrated progressive improvement with intervention: Her THI score reduced from 54 (moderate handicap) to 12 (slight handicap) over 3 months. Qualitative reports also indicated reduced intensity of hallucinations, improved emotional coping, and enhanced social engagement.

This case underscores the potential for nonpharmacological auditory interventions to alleviate MES-related distress, even in idiopathic cases with normal hearing. The findings challenge traditional assumptions linking MES strictly to hearing loss and support expanding diagnostic and therapeutic frameworks for younger populations.