Persistent Auditory Symptoms (Hearing Changes)
Type: Persistent aura symptom — may last weeks, months, or years. Often bilateral (affecting both sides of vision or both ears). Rare but well-documented.
What is it?
Persistent auditory symptoms involve ongoing changes in hearing that do not resolve after the migraine aura episode ends. This includes reduced hearing sensitivity (hypacusia), heightened sensitivity to sound, and musical palinacusis (hearing a melody repeatedly in the mind without an external source).
What it feels like
With reduced hearing, sounds seem muffled or distant, as though you are hearing through cotton or underwater. You may have difficulty hearing conversation, particularly in noisy environments. With hypersensitivity to sound, ordinary environmental sounds feel intrusive or painful—even normal conversation or moderate noise levels cause discomfort or distress. Musical palinacusis is the persistent, unwanted replay of melodies in your mind without any external source of music. The tune repeats or loops, sometimes for hours, and you cannot turn it off or change it, even when you are trying to concentrate on something else.
How patients describe it
“I am trying to find out if there is a connection between temporary hearing loss and migraine headaches. I am looking into temporary hearing loss, tunnel hearing during an episode.” — M.H.
“My husband says that I get very loud (well louder than usual) when I am going to get a migraine. Everything seems so far away.” — R.N.
“I’ve had monthly migraines fairly consistently for 20 years. I believe that mine are hormonally caused. One result which I’ve noticed more and more over the past 5 years is that my sense of smell, taste and hearing has changed.” — D.D.
What makes it worse
Reduced hearing may worsen in noisy environments or when trying to follow conversation in background noise. Hypersensitivity to sound worsens in loud environments, busy settings, or around sudden or unexpected noises. Stress and anxiety can increase awareness of and distress about auditory symptoms. Fatigue and lack of sleep may exacerbate hearing difficulties. Some patients report worsening during or around menstrual cycles. Alcohol and caffeine may affect hearing sensitivity in some cases.
What may help
For hypersensitivity to sound, some patients benefit from earplugs or noise-canceling headphones in loud environments. Avoiding unnecessary noise exposure and creating a quiet home or work environment helps many. Stress reduction and mindfulness techniques can reduce the distress associated with sound sensitivity. Cognitive behavioural therapy approaches can help patients manage the anxiety associated with auditory symptoms. For musical palinacusis, distraction techniques, listening to different music, or engaging in other mental activities may interrupt the involuntary replay.
Related symptoms
- Tinnitus (ringing in the ears)
- Vertigo or dizziness
- Speech or language difficulties
- Synaesthesia (cross-wiring of senses)
Clinical note
Hypacusia (reduced hearing) is reported by 4 of 60 subjects, hypersensitivity to sound by 3 subjects, and musical palinacusis by 2 subjects with definite persistent aura. These symptoms may be related to basilar-type migraine, which includes hearing loss as a characteristic aura symptom. Audiological evaluation is important to rule out primary hearing disorders. Evaluation by a neurologist helps confirm persistent aura as the cause. A normal brain MRI supports the diagnosis. These symptoms can usually be managed with appropriate environmental modification and coping strategies.
If this is the first time you experience these symptoms, or they feel different from previous episodes, seek medical evaluation to rule out other causes.