Acoustic shock controversies

Abstract

The diagnosis 'acoustic shock' has been made increasingly in the health care industry in recent years. This paper aims to question the validity of acoustic shock as an organic pathological entity. The experiences of 16 individuals diagnosed as having acoustic shock, within a medico-legal practice, are reviewed. The commonest symptom was otalgia, followed by noise sensitivity, tinnitus, hearing disturbance and dizziness. The presence of noise-limiting technology in the workplace, the variation in the nature of the acoustic incident involved (ranging from a shriek, through feedback noise, to a male voice), and the marked variation in the time of symptom onset (following the acoustic incident) all suggest that the condition termed acoustic shock is predominantly psychogenic. Cases of pseudohypacusis indicate that malingering is a factor in some cases. Clusters of acoustic shock events occurring in the same call centres suggest that hysteria may play a part. The condition is usually only seen when work-related issues are apparent.