DIAGNOSIS AND TREATMENT OF MISOPHONIA AND HYPERACUSIS BASED ON THE NEUROPHYSIOLOGICAL MODEL

The complaints of patients with hyperacusis and misophonia are very similar, and frequently identical. However, there are distinctive differences between these conditions. The recognition of these differences is crucial to properly diagnose and treat hyperacusis and misophonia. Audiological evaluation, while helpful, is not sufficient for differential diagnosis. Specific patient interview is critical. The treatment for hyperacusis is based on the desensitization of auditory subconscious pathways and it is aimed at decreasing abnormally increased gain within the auditory system. For misophonia the treatment involves utilization of passive and active extinction of subconscious conditioned reflexes as well as purposefully creating and modifying complex conditioning stimuli. The treatments for both conditions include counseling and sound therapy but they are distinctively different. The treatment effective for hyperacusis is not successful for misophonia and the treatment for misophonia has limited effectiveness for hyperacusis. The treatment of Decreased Sound Tolerance (DST), based on the Neurophysiological Model of Tinnitus and Decreased Sound Tolerance, showed over 80% success rate of clinically significant improvement and can even provide a cure for hyperacusis and misophonia.