Listening to the Music and the Patient

Abstract

The 52-year-old patient has had reduced hearing since 1993. She started hearing constant music, increasing over 2–3 years in frequency and intensity. The songs are only parts of a song that then will repeat endlessly until she tries to change it. Environmental input like TV can help. She is currently fully deaf on the right, and the left is significantly impaired. She has had hearing aids since 10 years; adjusting them did not help. She briefly took an SSRI a few years ago when she had episodes of low mood but has no major psychiatric co-morbidity and continues to work. MRI head was normal. Since starting Rivastigmine first at 1.5 mg once a day and then at BD she had four to five periods where it was quite for up to 20 minutes which gave her an elated feeling. This occurred when she was calm, happy and relaxed. There has been no change in volume but there has been a change in music of previously clearly hearing proper lyrics where now she is just hearing a brief melody. She finds it more difficult to change the tunes. It has not changed her spontaneous residual inhibition of one second of starting after sounds like talking stop. This improvement was not deemed meaningful and we are continuing to explore the unpredictable effects of cochlear implants on these symptoms and trying other medication.