The sound of silence

摘要

In January, 2011, a previously well 68-year-old woman, presented to our neurology outpatients department with a 6 week history of hearing a male voice singing and gradual bilateral hearing loss over the course of 1 year. The singing started suddenly with songs she knew from her childhood, and more recently she also reported hearing a choir. The singing was perceived as external, heard only in the left ear, and continued all day and night. She reported that the voices were irritating, particularly when trying to sleep. They stopped when she fell asleep and did not interfere with her daytime activities. She had insight that the voices were imaginary but said that she could not "switch them off" and did not recall any specific triggers.