Symptoms of hyperacusis

The main symptom of someone suffering from hyperacusis is intolerance to moderate or even mild sounds. Exposure to sounds causes discomfort and pain, and sounds are perceived as louder than they really are. It can occur in one or both ears.

Some examples of everyday sounds commonly reported as intolerable are the noise produced when handling crockery, children’s shrieks, barking dogs, the sound of small speakers such as those of a mobile phone or laptop, vehicle traffic noise, alarms, sirens, electronic beeps from devices and household appliances, crumpling plastic bags, or clapping. In general, high-frequency sounds are the most bothersome.

Not all people with hyperacusis experience this symptom in the same way; some do not feel pain when exposed to sounds or the pain is very mild, and some do not perceive sounds as excessively loud.

In addition to the main symptom, other related symptoms may appear; some are very common and others appear rarely. These symptoms are as follows:

• Tinnitus (also known as ringing in the ears). These are subjective noises perceived by the ears despite the absence of any external physical stimulus. They can increase in volume when exposed to sounds above the tolerance threshold.
• Sensation of blocked ears.
• Localized pain in the inner ear. This is described as sharp and intense pain, mild pain, or burning in the ear.
• Sound distortion. It may also be perceived as a metallic sound.
• Autophony (uncomfortable resonance of one’s own voice).
• Tingling or itching sensation in the ear.
• Radiating pain to areas innervated by the trigeminal nerve (cheek, jaw, teeth, scalp, maxillary sinuses, anterior part of the tongue, etc.).
• Muffled sound sensation.
• Eardrum flutter.
• Middle-ear sounds (objective, not tinnitus) triggered when speaking, swallowing, or yawning.
• Headache.
• Vertigo and balance disorders.
• Sore throat.

Hyperacusis can also involve psychological symptoms. Difficulties coping with the physical symptoms in daily life may lead to fear of sounds (known as phonophobia), or may produce negative emotional responses to sound exposure such as anger, anxiety, or even hatred.