Tinnitus, Hyperacusis, Otalgia, and Hearing Loss

PURPOSE OF REVIEW This article reviews the causes of tinnitus, hyperacusis, and otalgia, as well as hearing loss relevant for clinicians in the field of neurology.

RECENT FINDINGS Important causes of unilateral and bilateral tinnitus are discussed, including those that are treatable or caused by serious structural or vascular causes. Concepts of hyperacusis and misophonia are covered, along with various types of neurologic disorders that can lead to pain in the ear. Hearing loss is common but not always purely otologic.

SUMMARY Tinnitus and hearing loss are common symptoms that are sometimes related to a primary neurologic disorder. This review, tailored to neurologists who care for patients who may be referred to or encountered in neurology practice, provides information on hearing disorders, how to recognize when a neurologic process may be involved, and when to refer to otolaryngology or other specialists.

Address correspondence to Dr Terry D. Fife, Barrow Neurological Institute, 240 W Thomas Rd, Ste 301, Phoenix, AZ 85013, [email protected].

RELATIONSHIP DISCLOSURE: Drs Fife and Tourkevich report no disclosures.

UNLABELED USE OF PRODUCTS/INVESTIGATIONAL USE DISCLOSURE: Drs Fife and Tourkevich discuss the unlabeled/investigational use of carbamazepine, gabapentin, oxcarbazepine, or pregabalin for the treatment of certain types of pulsatile pulse-asynchronous tinnitus; baclofen, carbamazepine, clonazepam, onabotulinumtoxinA, or oxcarbazepine for the treatment of palatal or middle ear myoclonus; and betahistine for the treatment of Ménière disease.