Musical ear syndrome (MES) describes a condition seen in people who have hearing loss and subsequently develop auditory hallucinations. "MES" has also been associated with musical hallucinations, which is a complex form of auditory hallucinations where an individual may experience music or sounds that are heard without an external source. It is comparable to Charles Bonnet syndrome (visual hallucinations in visually impaired people) and some have suggested this phenomenon could be included under this diagnosis.
Musical hallucinations and MES have only become widely recognizable in the last few decades of research, but there are indications throughout history that have described symptoms of musical hallucinations. The Romantic composer Robert Schumann was said to have heard entire symphonies in his head from which he drew as inspiration for his music, but later in his life this phenomenon had diminished to just a note that played ceaselessly within his head. An alternative explanation is that his symptoms were caused by syphilis or mercury poisoning used for its treatment. The Russian composer Dmitri Shostakovich was also recorded as experiencing music hallucinations after some shrapnel was removed from his skull.
The occurrence of MES has been suggested to be very high among the hearing impaired through acquired deafness or the ear condition known as tinnitus. Though exact causation is uncertain, it has been theorized that the "release phenomenon" is taken into effect. The "release phenomenon" says that individuals with acquired deafness may experience musical hallucinations because the lack of stimulation, which can give room for the brain to interpret internal sounds as being external.
Sufferers typically hear music or singing and the condition is more common in women. The hallucinatory experiences differ from that commonly experienced in psychotic disorders although there may be some overlap. The most important distinction is the realization that the hallucinations are not real. Delusional beliefs associated with the hallucinations may occur, but some degree of insight should be preserved. There should not be any other psychotic symptoms present, especially hallucinations in other modalities.