Hyperacusis vs. Autophony?

I'm trying to better understand the difference between hyperacusis and autophony, as some of what I read and and what my doctor said seems ambiguous or contradictory.

As I understand it, hyperacusis is an increased sensitivity to everyday environmental sounds, often resulting in pain and/or vestibular symptoms. Some people report being sensitive to the sound of their own footsteps, which they seem to hear loudly or feel in their ear.

Autophony, on the other hand, is often described as hearing your own voice loudly, although some places I've seen it described as also hearing other "self-generated" sounds, such as heartbeat, footsteps, chewing/swallowing, breathing, and eye movement.

So I don't know how to interpret my own symptoms, which are primarily in one ear. I have pulsatile tinnitus, a chiming type of noise that occurs in sync with every heartbeat. (They've done all the typical tests--MRI, MRA, CT--and all came back normal.) Chewing sounds louder than before, and I can't chew gum anymore because the squelching sound drive me nuts. When I shake my head back and forth or tap on it, it rings. If someone pats me on the back my whole head rings, like my back is the pedal and my head is the drum. When I close my eyes, I hear a creaking type noise, like the sounds of my eye muscles moving. But most annoying of all, I get a clanging noise in my ear with every footstep--it sounds as if I'm walking by a shelf full of glassware that's rattling with each step. Do people get this with hyperacusis? It doesn't seem like I'm hearing it loudly from the outside though, but more like it's being transmitted from my heel, through my body, and crashing into my ear.

To me, these sounds all feel internal...but my doctor considers this to be hyperacusis, not autophony. Maybe because my voice doesn't sound loud? Other than a kind of an echo or "kazoo-like" sound when I hum low notes or speak m's or n's, my voice sounds pretty normal to me. And I do have some increased sensitivity to external sounds, so maybe hyperacusis is accurate? For example, the ventilation system in my favorite grocery store suddenly bothers me (annoying, but not uncomfortable), and my husband's sneezes sound so loud now they make me jump.

But on balance, I'd say the internal sounds are much more prevalent and bothersome than the outside sounds, so I don't know what to make of the "hyperacusis" label. Is this consistent with what others experience as hyperacusis? Maybe mild hyperacusis? Is it maybe also autophony? Or are there different terms to describe some of these? I guess labels don't really matter, but since there don't seem to be any answers as to why I have these symptoms, at least knowing what to call them would be something!

 

Put simply
Autophony=Increased hearing of internal sounds.
Examples:
-Hearing of heartbeat is more prevalent
-One can hear their eyes move
-Ones voice is louder and sometimes deafening
-One can hear their blood flow usually near ears
-Sound of ones breathing seems louder and more pronounced,like when you block your ears and breath through your nose,the sound is more focused.

Hyperacusis=An increased sensitivity to sound in general,resulting in pain and or intolerance that would not bother a normal person.
Examples:
-Can't tolerate dogs barking
-Can't tolerate certain beeps or chirps
-Can't tolerate someone shouting
-Can't tolerate children screaming
-Can't tolerate tv at higher volume
-High frequency noises like plates banging is painful or intolerable.

Sounds may or may not result in pain,the purr of a cat feels like a lions roar for someone with severe Hyperacusis.

Hope this helps.

 

@brodi

I am not a doctor, but some of your symptoms sound consistent with a condition called SCDS (Superior Canal Dehiscence Syndrome). It is fairly rare and and many medical professionals are not familiar with it, so unless your doctors are knowledgeable and have specifically ruled it out, I would suggest looking into it. There is an extremely helpful Facebook group for SCDS where you can learn more and ask questions about your situation, including finding a doctor near you who is skilled in diagnosing and treating the condition.

https://www.facebook.com/groups/221257197900489/

Good luck!

 

@ lymebite, I had the same thought as you, and pushed for a CT scan. Just got the results back, and no SCD seen. I suppose that's good news in that there's no potential surgery, but it's still a little disappointing. Thanks for the suggestion though!

@ bill 112, thanks. That's pretty consistent with my understanding, but where would something like the clanging noise with each heel strike fall? It's not really an internally generated sound, but I'm not hearing is a footstep noise, either. It's more like my brain rattling on impact.

I also have a new symptom related to eye movement, but somehow it seems to be external rather than internal, if that's possible. When I shut my eyes, I hear a rumbling/creaking sound in my good ear. It sounds like a muscle working (tensor tympani, probably), so I assumed it was internal. But if I cover my good ear, I can't hear it--so it seems like it's more external. I know some people can strain to make that sound, but I had never heard it before--and now I can get it every time I close my eyes. Maybe it was always there, and it's just that now I can hear it! This is all so wacky...

 

Hi Brodi,

I happen to have Superior Canal Dehiscence and came across your post. I think we should discuss more. Your symptoms are a strong fit for this condition. There are cases where the CT can is done with the wrong resolution or interpreted incorrectly. I don't have much time at the moment, but I would really like to discuss this more with you. If you can hear your eye movements in a quiet room it is highly likely you have SCDS. I am not aware of any other condition that has this symptom.

Chat more soon
Jeff,

 

I think you'll always get some crossover of symptoms, but the way I see it, SCDS involves more of a reaction and awareness of internally generated somatic sound, and hyperacusis involves a mis-perception mostly of external sounds (volume and/or frequency distortion).

Main difference? SCDS is a diagnosis, hyperacusis is a symptom.