A to Z of Medical Conditions

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Hyperacusis and Photophobia- what it matter

Hyperacusis

Hyperacusis

 

Hyperacusis is the name for intolerance to everyday sounds that causes significant distress and affects a person’s day-to-day activities.

The condition can vary quite a lot. For example, some people find loud noises extremely uncomfortable, some find certain noises particularly annoying, some develop a fear of certain noises, while others experience pain when hearing ordinary sounds.

Hyperacusis affects people of all ages and is quite common in children.

The condition may just be a minor nuisance for some, but for many it can have a major impact on their life.

 

Symptoms of hyperacusis

Hyperacusis can either start suddenly or develop gradually over time.

When someone with the condition hears noise, they may:

feel uncomfortable

cover their ears or try to get away from the noise

feel angry, tense, distressed, or anxious

experience pain – hyperacusis can be very painful for some people

Some people become afraid of sound and avoid noisy situations, causing them to become socially isolated. School and work life can also suffer as it can be very difficult to concentrate.

When to get medical help

Visit your GP if you have a severe sound intolerance. They can examine your ears and refer you to an ear, nose and throat (ENT) consultant or a hearing specialist (audiologist) for tests if necessary.

There are no tests that can definitively diagnose hyperacusis, but you may be asked to fill in a questionnaire about your symptoms and have a hearing test to determine what level of sound causes a reaction.

Treatments for hyperacusis

There are no specific medicines or operations that can treat hyperacusis, although treating any underlying cause may help resolve the problem.

If there’s no clear cause, specialist techniques to help reduce your sensitivity to noise may be recommended.

These therapies are widely available privately, and may be available on the NHS for people with severe or persistent hyperacusis. They should only be carried out by someone specially trained in the correct techniques.

Treatment may involve:

cognitive behavioural therapy (CBT) – this aims to help you explore and change the way you think about the troublesome noises to reduce distress, change your avoidance behaviour, and help you recover from your hyperacusis symptoms

counselling and education – to support you and help you learn more about your hyperacusis

sound therapy (desensitisation) – this aims to help desensitise your hearing over several months, using special noise generators either placed in the room or in your ears (similar to hearing aids)

lifestyle changes – including learning relaxation techniques, listening to calming music or sounds, not avoiding noisy situations, and not using earplugs or muffs (these may make your ears more sensitive)

Recent research suggests patients often feel CBT, counselling and education are the most effective treatments. Some people also found sound therapy helpful, but it wasn’t clear whether it provided any additional benefit.

You may also find it helpful to get in touch with a support group, such as the British Tinnitus Association and Action on Hearing Loss, to talk to other people with hyperacusis and share your experiences.

Causes of hyperacusis

The cause of hyperacusis is unclear. It has been linked with a number of other conditions, although many people with hyperacusis don’t have any other obvious problems.

Hyperacusis has been associated with:

tinnitus – hearing sounds that come from inside your body, rather than from an outside source

hearing loss – the brain may sometimes compensate for reduced hearing by amplifying signals coming from the ears

damage to the ear or brain – including from a head injury, ear surgery, exposure to loud noise, earwax removal, glue ear, and persistent ear infections

migraines

Bell’s palsy – a type of facial paralysis

Ménière’s disease – a disorder of the inner ear that causes a spinning sensation (vertigo), tinnitus, and hearing loss

depression and post-traumatic stress disorder (PTSD)

Addison’s disease – a rare disorder of the adrenal glands, which sit near the kidneys and produce important hormones

disorders affecting the brain – such as Williams’ syndrome or autism spectrum disorder

Hyperacusis can also be a side effect of certain medications. If you’re taking any medication, check the leaflet it comes with to see if hyperacusis is listed as a possible side effect.

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Polycystic ovary syndrome – what are the signs of PCOS?

Polycystic ovary syndrome

Polycystic ovary syndrome

Symptoms Of PCOS

If you experience symptoms of polycystic ovary syndrome (PCOS), they’ll usually become apparent in your late teens or early twenties.

Not all women with PCOS will have all of the symptoms, and each symptom can vary from mild to severe. Many women only experience menstrual problems and/or are unable to conceive.

Common symptoms of PCOS include:

irregular periods or no periods at all

difficulty getting pregnant (because of irregular ovulation or failure to ovulate)

excessive hair growth (hirsutism) – usually on the face, chest, back or buttocks

weight gain

thinning hair and hair loss from the head

oily skin or acne

You should talk to your GP if you have any of these symptoms and think you may have PCOS.

Fertility problems

PCOS is one of the most common causes of female infertility. Many women discover they have PCOS when they’re trying to get pregnant and are unsuccessful.

During each menstrual cycle, the ovaries release an egg (ovum) into the uterus (womb). This process is called ovulation and usually occurs once a month.

However, women with PCOS often fail to ovulate or ovulate infrequently, which means they have irregular or absent periods and find it difficult to get pregnant.

Risks in later life

Having PCOS can increase your chances of developing other health problems in later life. For example, women with PCOS are at increased risk of developing:

type 2 diabetes – a lifelong condition that causes a person’s blood sugar level to become too high

depression and mood swings – because the symptoms of PCOS can affect your confidence and self-esteem

high blood pressure and high cholesterol – which can lead to heart disease and stroke

sleep apnoea – overweight women may also develop sleep apnoea, a condition that causes interrupted breathing during sleep

Women who have had absent or very irregular periods (fewer than three or four periods a year) for many years have a higher-than-average risk of developing cancer of the womb lining (endometrial cancer).

However, the chance of getting endometrial cancer is still small and can be minimised using treatments to regulate periods, such as the contraceptive pill or an intrauterine system (IUS).

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Synaesthesia – so what actually is Synaesthesia ?

Synaesthesia

Synaesthesia

Introduction

Synaesthesia is a condition where a sensation in one of the senses, such as hearing, triggers a sensation in another, such as taste.

For example, some people with synaesthesia can taste numbers or hear colours.

A wide range of different synaesthetic experiences have been reported and recorded – a typical example is someone who described experiencing the colour red every time he heard the word “Monday”.

What are the different types of synaesthesia?

There are many different types of synaesthesia, and many people with synaesthesia will experience more than one of these – for example, taste, sound and touch may all produce colours.

Colours and patterns

Research suggests that the most common synaesthetic experiences are associating days, months, numbers and the alphabet with:

patterns or shapes (for example, envisaging the months laid out in lines, spirals or circles)

distinctive colours – for example, “A” may be red and “B” may be blue

Synaesthesia affects people differently. Two people with synaesthesia will often disagree over the colour of letters.

However, there are some trends that appear common to all people with the condition – A is generally perceived as red, B is often blue, and C is often yellow.

Taste and smell


For some people with synaesthesia, spoken words trigger a particular taste, as well as a particular texture, place in the mouth and temperature (for example, “runny egg yolk”).

Taste can also produce colour sensations, or shapes that can be “felt”.

Certain odours may also be perceived as shapes and/or colours, but this form of synaesthesia is thought to be rare.

Touch and other body sensations

Some people experience touch just by looking at someone being touched. This is known as “mirror touch” synaesthesia.

Feelings of pain or touch can also trigger visions or colour, and there has been a documented case of words triggering feelings of body movement.

Advice for people with synaesthesia

Most people with synaesthesia have had it since childhood, so it feels perfectly normal to experience the world in this way. It’s not obtrusive and does not affect day-to-day life. It’s not necessary to see a doctor.

If you think your child has synaesthesia

If you are a parent of a child with synaesthesia, you may wish to discuss it with their teacher so they are aware of it. There is evidence that synaesthesia affects educational ability, either by slightly distracting the pupil, or (most often) by giving slight learning advantages.

It may also be true that your child will learn in different ways to other children. For instance, many people with synaesthesia report a visual style of thinking.

If it comes on suddenly in adulthood

If you suddenly begin to experience symptoms of synaesthesia for the first time as an adult, it’s a good idea to see your GP for an assessment.

This is because there could be underlying factors related to your brain and nervous system that may need investigating.

Is synaesthesia linked to other conditions?

Because the number of people with synaesthesia is relatively small, it is not yet possible to know this conclusively.

An Australian study did not find any evidence of an association between synaesthesia and various mental health problems. In fact, there is growing evidence that synaesthesia may be linked to certain advantages, including enhanced memory, superior perception and being able to think more quickly.

Two small studies published in 2013 suggest that synaesthesia is more common in adults with autism (also known as autistic spectrum disorder) than in adults who do not have an autistic spectrum disorder.

The studies involved screening people with and without autism for synaesthesia. In adults with autism, the prevalence of synaesthesia was estimated to be 17-19%, whereas adults without autism have a much lower prevalence of 2% (for more information, read NHS News: Synaesthesia may be ‘more common’ in autism).

These results appear broadly reliable, but they need to be confirmed in larger studies. If true, these findings imply that the two conditions may share some common cause in the brain.

However, it’s important to note that most people with autism do not have synaesthesia, and that most people with synaesthesia do not have autism.

What’s the cause?

It’s likely that the brain of someone with synaesthesia is “wired” differently, or has extra connections.

A brain imaging study has shown that when some people with synaesthesia hear spoken words, a part of their brain normally used to process colour from vision lights up.

Synaesthesia runs in families, although it may skip a generation and may not affect immediate relatives. It’s possible for only one twin to have the condition, or for family members to show different types of synaesthesia. In summary, there is a genetic contribution to synaesthesia, but the environment is also important.

It’s possible for people to “grow out of” synaesthesia: there have been cases of people claiming that they used to experience synaesthesia, but no longer do.

How do people with synaesthesia feel about their condition?

Interviews with people who have synaesthesia show a wide range of feelings towards their condition.

Many are positive about it (“I feel sorry for people who don’t have this”), and can’t imagine their life without it.

Some feel neutral about it, and treat it as something they’ve become used to, which doesn’t affect them in any way.

For a minority, the sensations can disrupt their chain of thought and be intrusive.

How common is it?

Synaesthesia has been estimated to affect at least 4% of the UK population.

Researchers at the University of Sussex have estimated that 1-2% of the UK population experience colour when they see, hear or think about letters and numbers, and that synaesthesia is just as common in women as in men (read the study).

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Tourette’s syndrome – what are the signs and symptoms of Tourette’s syndrome?

Tourette's Syndrome

Tourette’s Syndrome

Symptoms of Tourette’s syndrome

If your child has tics, it doesn’t necessarily mean they have Tourette’s syndrome.

Children often develop tics before growing out of them after several months. These are known as transient tics.

For tics to be classified as Tourette’s syndrome, they have to be present for at least a year and include at least one vocal tic.

Tics can be:

vocal (sounds) – such as grunting, coughing or shouting out words

physical (movements) – such as jerking of the head or jumping up and down

Tics can also be:

simple – for example, making a small movement or uttering a single sound

complex – for example, making a series of movements or speaking a long phrase

Most people diagnosed with Tourette’s syndrome have a combination of physical and vocal tics, which can be both simple and complex.

Simple vocal tics

Examples of simple vocal tics include:

grunting

clearing the throat

coughing

screaming

sniffing

squeaking

blowing

Simple physical tics

Examples of simple physical tics include:

blinking

jerking the head

twitching the nose

teeth grinding

rolling the eyes

twisting the neck

rotating the shoulders

Complex vocal tics

Examples of complex vocal tics include:

repeating other people’s phrases (echolalia)

repeating the same phrase over and over again (palilalia)

swearing loudly or shouting inappropriate words and phrases (coprolalia)

Swearing is often associated with Tourette’s syndrome, but it’s actually a fairly uncommon symptom affecting a minority of people with the syndrome.

Complex physical tics

Examples of complex physical tics include:

shaking the head

hitting or kicking objects

jumping

shaking

touching themselves or others

copying the movements of others (echopraxia)

making obscene gestures, such as giving someone ‘the finger’ (copropraxia)

Premonitory sensations

Most people with Tourette’s syndrome experience uncomfortable or unusual feelings before having a tic. These feelings are known as premonitory sensations.

Premonitory sensations are only relieved after the tic has been carried out, in a similar way to how an itch can only be relieved by scratching it.

Examples of premonitory sensations include:

a burning feeling in the eyes that feels as if it can only be relieved by blinking

tension in a muscle that can only be relieved by twitching or stretching the muscle

a dry or sore throat that can only be relieved by grunting or by clearing the throat

an itchy joint or limb that can only be relieved by twisting the joint or limb

Pattern of tics

If your child has Tourette’s syndrome, their tics will probably tend to follow a set pattern. They may be worse during periods of:

stress

anxiety

tiredness

illness

nervous excitement

relaxation after a busy day

On the other hand, the tics are often reduced when they’re doing an enjoyable activity involving a high level of concentration, such as reading an interesting book or playing competitive sports.

You may find your child is able to control their tics when they’re in situations where they would be particularly noticeable, such as in a school classroom. However, controlling tics can be difficult and tiring over prolonged periods of time.

Many children with Tourette’s syndrome often experience a sudden ‘release’ of tics after trying to suppress them – for example, after returning home from school.

When to seek medical advice

You should contact your GP if either you or your child starts experiencing tics.

Many children have tics for several months before growing out of them, so a tic doesn’t necessarily mean your child has Tourette’s syndrome.

However, symptoms such as tics do need to be investigated.

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Hypothyroidism – what are the signs of an underactive thyroid?

Hypothyroidism

Hypothyroidism

Many symptoms of an underactive thyroid (hypothyroidism) are the same as those of other conditions, so it can easily be confused for something else.

Symptoms usually develop slowly and you may not realise you have a medical problem for several years.

Common symptoms include:

tiredness

being sensitive to cold

weight gain

constipation

depression

slow movements and thoughts

muscle aches and weakness

muscle cramps

dry and scaly skin

brittle hair and nails

loss of libido (sex drive)

pain, numbness and a tingling sensation in the hand and fingers (carpal tunnel syndrome)

irregular periods or heavy periods

Elderly people with an underactive thyroid may develop memory problems and depression. Children may experience slower growth and development. Teenagers may start puberty earlier than normal.

If you have any of these symptoms, see your GP and ask to be tested for an underactive thyroid.

Read more about getting tested for an underactive thyroid.

If an underactive thyroid isn’t treated

It’s unlikely that you’d have many of the later symptoms of an underactive thyroid, because the condition is often identified before more serious symptoms appear.

Later symptoms of an underactive thyroid include:

a low-pitched and hoarse voice

a puffy-looking face

thinned or partly missing eyebrows

a slow heart rate

hearing loss

anaemia