Auditory Hallucinations in Patients With Acquired Hearing Loss: A Case Series

Abstract

Introduction: Auditory hallucinations are a common but underrecognized symptom in those with hearing impairment. The pathophysiology is poorly understood but hypothesized to be related to deafferentation phenomenon.

Case presentations: We describe the cases of 2 patients with bilateral acquired hearing loss and no previous history of psychosis who reported distressing auditory hallucinations. Case 1 involves a woman in her 60s who presented with both auditory and visual hallucinations and associated delusions that did not respond to olanzapine but responded well to sertraline and a low dose of quetiapine. Case 2 involves a man in his late 70s with progressively worsening auditory hallucinations with associated delusions who responded well to treatment with risperidone.

Discussion: Despite centuries of documentation about hallucinations in sensory impairment, its pathophysiology is not completely understood, nor is there consensus regarding treatment.

Conclusions: Health care providers should be aware of the prevalence of auditory hallucinations in those with hearing impairment, particularly when symptoms are misattributed to primary psychotic disorders or neurodegenerative conditions. A biopsychosocial approach, including psychoeducation, behavioral and environmental modifications, and family involvement can yield significant improvement and even resolution of symptoms.