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case study: man hears his heart beat, eyes move

new symptoms arose, including dizziness and a sensation his vision was pulsing to the rhythm of his voice.

hearing your own heart beat a rare syndrome
the unsettling sounds began to drown out the world around him. getty
each week we comb through science journals to explore a baffling medical issue.
the sound of silence became a distant dream for an englishman who gained the maddening ability to hear his own heartbeat.
stephen mabbutt, a 57-year-old from charlton, london, became increasingly distressed as the pulsating pattern was soon joined by the noise his eyeballs made as they moved around inside his head. the unsettling sounds began to drown out the world around him. “when i raised my voice, i could hear it reverberating in my head and the vibrations made my vision vibrate,” mabbutt said. “eventually i could hear my heart beating and my eyes moving in their sockets. it was really distracting.”

the ordeal began in 2005 when mabbutt began to experience a dull ache on one side of his head, according to the bbc . puzzled health practitioners treated him repeatedly with nasal sprays and antibiotics but were unable to keep his hearing from deteriorating. new symptoms would soon arise, including dizziness and a sensation his vision was pulsing to the rhythm of his voice.

a trip to an ear expert resulted in a diagnosis of superior canal dehiscence syndrome (scds), a rare condition that is caused by an abnormal opening in the upper canal of the vestibule in the inner ear, according to john hopkins medicine . often caused by head trauma, scds can make people hypersensitive to sounds inside their own body. the condition, which is notoriously difficult to diagnose, causes loud noises, coughs or sneezes to become distorted, resulting in an intense sense of vertigo.

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“the actual muscles that move the eyes are connected to the bones of the skull and there is an element of friction as these muscles move,” said richard irving, the ear expert who treated mabbutt. “some patients, as their eyes move from side to side, hear that friction movement of the muscle as a noise in their ear. it destroys their quality of life. the symptoms were so confusing that those of us in the medical profession just scratched our heads and didn’t understand it until this was described.”

mabbutt was sent to the ear expert by martin burton, a surgeon who performed a ct scan on the patient and noticed tiny perforations in the semicircular canals of his ear that would lead to the elusive diagnosis and put him on the road to recovery.
“there may be an annual incidence of one in 500,000 a year in the u.k. population,” irving said. “symptoms include hearing loss and balance problems, particularly provoked by loud noises or pressure changes in the head. i’ve had a patient who fell over whenever they burst out laughing. you hear all interior sounds of the body particularly loud.”
the main method of treating scds involves surgery to seal the hole in the superior canal and prevent changes in pressure between the ear and the brain cavity. doctors made a two-inch incision behind mabbutt’s ear and created a path to the vestibular system (also known as the organ of balance) inside the inner ear. they sealed the area around the opening using the patient’s own bone matter.

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“i was just hoping and hoping somebody would put their finger on it at some point and tell me what was going on,” he said. “it was getting me down not knowing what it was and whether or not it could be cured.
“it feels great now. i feel like i’ve got a new lease of life. i’ve got more energy and i feel brighter. it’s an amazing difference.”

dave yasvinski is a writer with healthing.ca

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