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Tinnitus is the false perception of sound (such as ringing) – it generally occurs when the acoustic environment is quiet. It occurs in about 15% of all people, and is most common in hearing loss caused by excessive noise. Many illnesses can cause tinnitus, and it can be a side effect of medication or drugs-of-abuse.

The majority of people with tinnitus can suppress or otherwise ignore the symptom. Unfortunately, about 1 in 50 people experience tinnitus as a severe problem and a form of chronic pain. It has been likened to phantom limb pain at a physiologic level, and can be just as upsetting as any of the other central pain syndromes.

It can be evaluated with the auditory evoked response – which is a standard test in most hospitals. It has been imaged to a very high level of resolution with MEG – first by Rodolfo Llinas & team and more recently by Dalton & Bowyer as they sought new treatment techniques.

It can occur along with other central pain syndromes such as depression, panic disorder, or CRPS/RSD, and as a “stand-alone” symptom in ear disease. It is not a laughing matter – it can be so painful as to cause suicide.

It can be treated with devices which are similar to noise-canceling hearing aids, is sometimes treated with rTMS or implanted brain stimulators, and often requires medication treatment. Medications include anti-convulsants, anti-depressants, analgesics, and NMDA receptor antagonists like memantine or ketamine.

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