Editing Hyperacusis (section)

==Signs and symptoms==
Hyperacusis symptoms can include an increased perception of the loudness of sounds (loudness hyperacusis), pain (noxacusis/pain hyperacusis/sound-induced otalgia), [[annoyance]], and/or fear in response to sounds by which most people are unaffected. It may affect one or both ears.<ref name="Williams-2021a" /> The majority of patients experience bilateral symptoms but often have one ear that is more affected than the other. Annoyance hyperacusis is often considered synonymous with [[misophonia]]. Fear hyperacusis is often considered synonymous with [[phonophobia]]. Many researchers more narrowly define hyperacusis to only include loudness hyperacusis and pain hyperacusis.<ref name="Williams-2021a" />

Hyperacusis can also be accompanied by [[tinnitus]]. The latter is more common<ref name="BTA">{{cite web |title=Hyperacusis |url= https://www.tinnitus.org.uk/hyperacusis |access-date=9 June 2020 |website=British Tinnitus Association |language=en}}</ref> and there are important differences between their involved mechanisms.<ref name="pmid24012803" />

Hyperacusis can result in [[anxiety]] and stress. Avoidant behavior is often a response to prevent the effects of hyperacusis and this can include avoiding social situations.<ref>{{Cite journal |last1=Henry |first1=James A. |last2=Theodoroff |first2=Sarah M. |last3= Edmonds |first3=Catherine |last4=Martinez |first4=Idalisse |last5=Myers |first5=Paula J. |last6=Zaugg |first6=Tara L. |last7= Goodworth |first7=Marie-Christine |date=September 2022 |title=Sound Tolerance Conditions (Hyperacusis, Misophonia, Noise Sensitivity, and Phonophobia): Definitions and Clinical Management |url=http://dx.doi.org/10.1044/2022_aja-22-00035 |journal= American Journal of Audiology |volume=31 |issue=3 |pages=513–527 |doi=10.1044/2022_aja-22-00035 |pmid=35858241 |issn=1059-0889|url-access=subscription }}</ref>

=== Loudness hyperacusis ===
Loudness hyperacusis is characterized by an increased perception of the loudness of sounds.<ref name="Williams-2021a" /> It is often associated with certain volumes and/or frequencies. It can occur in children<ref name=pmid29312994>{{Cite journal |last= Potgieter |first=I. |date=June 29, 2020 |title=Hyperacusis in children: a scoping review |journal=BMC Pediatr |volume=20, 319 |issue= 1 |page=319 |doi=10.1186/s12887-020-02223-5 |pmid=32600446 |pmc=7322835 |doi-access=free }}</ref> and adults,<ref>{{Cite journal |last1=Fackrell |first1=Kathryn |last2=Potgieter |first2=Iskra |last3=Shekhawat |first3=Giriraj S. |last4=Baguley |first4= David M. |last5=Sereda |first5=Magdalena |last6=Hoare |first6=Derek J. |date=2017 |title=Clinical Interventions for Hyperacusis in Adults: A Scoping Review to Assess the Current Position and Determine Priorities for Research |journal=BioMed Research International |volume=2017 |pages=1–22 |doi=10.1155/2017/2723715 |pmid=29312994 |pmc=5654244 |doi-access=free |issn= 2314-6133 }}</ref> and can be either "short-term" in a duration of weeks to less than a year before recovery, or, less commonly, "long-term," spanning years and in some cases becoming permanent. Sensitivity is often different between ears.<ref name="Pollard-2019">{{Cite journal |last=Pollard |first=Bryan |date=October 2019 |title=Clinical Advancements for Managing Hyperacusis with Pain |journal=The Hearing Journal |volume=72 |issue=10 |pages=10, 12 |s2cid=208398632 |doi=10.1097/01.HJ.0000602900.16223.0e |doi-access=free |url= https://journals.lww.com/thehearingjournal/Fulltext/2019/10000/Clinical_Advancements_for_Managing_Hyperacusis.4.aspx}}</ref>

=== Noxacusis ===
In some instances, hyperacusis is accompanied by pain, which is known as noxacusis.<ref>{{Cite web |last=Auerbach |first=Benjamin |date= January 1, 2019 |title=Physiological mechanisms of hyperacusis: an update |url= https://www.entandaudiologynews.com/features/audiology-features/post/physiological-mechanisms-of-hyperacusis-an-update |access-date= May 2, 2022 |website=ENT and Audiology News}}</ref> Noxacusis is characterized by pain resulting from sounds, often initiated at certain volumes or frequencies.<ref>{{Cite journal |last=Sheldrake |first=Jacqueline |date=May 15, 2015 |title= Audiometric Characteristics of Hyperacusis Patents |journal=Frontiers in Neurology |volume=6 |page=105 |doi= 10.3389/fneur.2015.00105 |pmid=26029161 |pmc=4432660 |doi-access=free}}</ref> Pain can be immediate or delayed, and it sometimes persists for an extended period of time following exposure.<ref name="Pollard-2019"/> Pain can be acute or chronic, and is often described as stabbing, burning, throbbing, or aching. In healthy listeners, pain from sound is not typically experienced until the volume exceeds approximately 120 decibels.<ref name="Williams-2021a" />

Individuals experiencing noxacusis report less improvement over time and fewer benefits from sound therapy compared to individuals with loudness hyperacusis.<ref name="Williams-2021b">{{Cite journal |last1=Williams |first1=Zachary J. |last2=Suzman |first2= Evan |last3=Woynaroski |first3=Tiffany G. |date=2021-06-14 |title=A Phenotypic Comparison of Loudness and Pain Hyperacusis: Symptoms, Comorbidity, and Associated Features in a Multinational Patient Registry |journal=American Journal of Audiology |volume=30 |issue=2 |pages=341–358 |doi=10.1044/2021_AJA-20-00209 |issn=1059-0889 |pmc=8642094 |pmid=33877881}}</ref>

=== Loudness discomfort level ===
The threshold of sound at which discomfort is initially experienced; measured in decibels (dB).<ref>{{Cite journal |last=Deihl |first= Peter |date=July 15, 2015 |title=Abnormal auditory gain in hyperacusis: investigation with a computational model |journal= Frontiers in Neurology |volume=6|page=157 |doi=10.3389/fneur.2015.00157 |pmid=26236277 |pmc=4502361 |doi-access=free }}</ref>

=== Setback ===
A setback is a temporary exacerbation of symptoms, a worsening of the perception of loudness or pain from sound, often due to a particular noise exposure.<ref name="Williams-2021a">{{Cite journal |last1=Williams |first1=Zachary J. |last2=Suzman |first2= Evan |last3=Woynaroski |first3=Tiffany G. |date=2021-06-14 |title=A Phenotypic Comparison of Loudness and Pain Hyperacusis: Symptoms, Comorbidity, and Associated Features in a Multinational Patient Registry |url=http://dx.doi.org/10.1044/2021_aja-20-00209 |journal=American Journal of Audiology |volume=30 |issue=2 |pages=341–358 |doi=10.1044/2021_aja-20-00209 |pmid=33877881 |pmc=8642094 |issn=1059-0889}}</ref> Setback prevention is an important focus among those affected. Efforts to avoid setbacks commonly include using hearing protection and avoiding loud noises.<ref name="Pollard-2019"/> Pain hyperacusis patients experience setbacks more frequently than patients with loudness hyperacusis.<ref name="Williams-2021a" />

=== Associated conditions ===
Some conditions that are associated with hyperacusis include:<ref name="Baguley, 2003"/><ref>{{Cite journal |last1=Danesh |first1=Ali A. |last2=Howery |first2=Stephanie |last3=Aazh |first3=Hashir |last4= Kaf |first4=Wafaa |last5=Eshraghi |first5=Adrien A. |date=2021-10-14 |title= Hyperacusis in Autism Spectrum Disorders |journal=Audiology Research |volume=11 |issue=4 |pages=547–556 |doi=10.3390/audiolres11040049 |doi-access=free |pmid=34698068 |pmc=8544234 |issn=2039-4349}}</ref>
{{div col|colwidth=35em}}
* [[Acoustic shock]]
* [[Adverse drug reaction]]
* [[Anxiety]]
* [[Asperger syndrome]]
* [[Attention deficit hyperactivity disorder]]<ref>{{cite journal | vauthors = Ralli M, Romani M, Zodda A, Russo FY, Altissimi G, Orlando MP, Cammeresi MG, Penge R, Turchetta R | display-authors = 6 | title = Hyperacusis in Children with Attention Deficit Hyperactivity Disorder: A Preliminary Study | journal = International Journal of Environmental Research and Public Health | volume = 17 | issue = 9 | pages = 3045 | date = April 2020 | pmid = 32349379 | pmc = 7246428 | doi = 10.3390/ijerph17093045 | doi-access = free }}</ref>
* [[autism|Autism spectrum]]
* [[Depression (mood)|Depression]]
* [[Endolymphatic hydrops]]<ref name="Møller 2011 p. 457">{{cite book | vauthors = Møller A | title= Textbook of tinnitus | publisher= Humana Springer distributor | location=Totowa, NJ; London | year=2011 | isbn=978-1-60761-145-5 | page=457}}</ref>
* [[Fetal alcohol spectrum disorder]]
* [[Hypothyroidism]]
* [[Lyme disease]]<ref name="Baguley, 2003"/>
* [[Migraine]]<ref name="Baguley, 2003">{{cite journal | vauthors = Baguley DM | title = Hyperacusis | journal = Journal of the Royal Society of Medicine | volume = 96 | issue = 12 | pages = 582–85 | date = December 2003 | pmid = 14645606 | pmc = 539655 | doi = 10.1177/014107680309601203 }}</ref>
* [[Ménière's disease]]
* [[Multiple sclerosis]]<ref name="Baguley 2007 p.">{{cite book | vauthors = Baguley D | title= Hyperacusis : mechanisms, diagnosis, and therapies | publisher=Plural Publishing | location=San Diego, CA | year=2007 | isbn=978-1-59756-808-1 | page= 59}}</ref>
* [[Noise-induced hearing loss]]
* [[Posttraumatic stress disorder]]<ref name="Baguley, 2003"/>
* Severe [[head trauma]]<ref name="Baguley, 2003"/><ref name= "Granacher 2008 p.">{{cite book | vauthors = Granacher R | title= Traumatic brain injury: methods for clinical and forensic neuropsychiatric assessment | publisher=CRC Taylor & Francis | location=Boca Raton, FL; London | year= 2008 | isbn= 978-0-8493-8139-3 | page=181}}</ref>
* [[Sjögren syndrome]]<ref>{{cite journal | vauthors = Montoya-Aranda IM, Peñaloza-López YR, Gutiérrez-Tinajero DJ | title = Sjögren's syndrome: Audiological and clinical behaviour in terms of age | journal = Acta Otorrinolaringologica (English Edition) | volume = 61 | issue = 5 | pages = 332–37 | year = 2010 | issn=2173-5735 | doi = 10.1016/S2173-5735(10)70061-2 | pmid = 20678744 | url = https://www.sciencedirect.com/science/article/pii/S2173573510700612 | url-access = subscription }}</ref>
* [[Superior canal dehiscence syndrome]]
* [[Systemic lupus erythematosus]]<ref name="pmid20576373">{{cite journal | vauthors = Maciaszczyk K, Durko T, Waszczykowska E, Erkiert-Polguj A, Pajor A | title = Auditory function in patients with systemic lupus erythematosus | journal = Auris, Nasus, Larynx | volume = 38 | issue = 1 | pages = 26–32 | date = February 2011 | pmid = 20576373 | doi = 10.1016/j.anl.2010.04.008}}</ref>
* [[Tay–Sachs disease]]<ref name="Desnick 2001 p.">{{cite book | vauthors = Desnick R | title= Tay–Sachs disease | url= https://archive.org/details/advancesgenetics00desn | url-access=limited | publisher= Academic | location=San Diego, [[California|CA]], USA; London | year=2001 | isbn=978-0-08-049030-4 | page= [https://archive.org/details/advancesgenetics00desn/page/n45  25]}}</ref>
* [[Temporomandibular joint disorder]]
* [[Tinnitus]]
* [[Tonic tensor tympani syndrome]]
* [[Trigeminal neuralgia]]
* [[Visual snow]]
* [[Williams syndrome]]<ref name="Baguley, 2003"/><ref name= "Zarchi">{{cite journal | vauthors = Zarchi O, Attias J, Gothelf D | title = Auditory and visual processing in Williams syndrome | journal = The Israel Journal of Psychiatry and Related Sciences | volume = 47 | issue = 2 | pages = 125–31 | year = 2010 | pmid = 20733255 }}</ref>
{{div col end}}