Palinacousis: an eloquent symptom of temporal lobe lesion

BMJ Case Rep. 2021 Apr 13;14(4):e236615. doi: 10.1136/bcr-2020-236615.

Abstract

A 24-year-old woman was referred to us for an intracranial haemorrhage in the left temporal lobe caused by a ruptured cavernous malformation; the bleeding extended over the left Heschl's gyrus and Wernicke area. On admission, the patient had global aphasia. A few days later, she spontaneously improved but remained with mild residual comprehensive dysphasia. She reported hearing, in her right ear, recently heard words, which is consistent with palinacousis. Auditory acuity testing was normal. EEG showed focal slowing in the left temporal region with no epileptiform activity. During awake surgery for resection of the cavernous malformation, stimulation of the superior temporal gyrus did not provoke palinacousis. The patient made good recovery with complete resolution of the aphasia and no recurrence of palinacousis. We aimed to review this phenomenon and to provide a systematic review of the current literature.

Keywords: epilepsy and seizures; neuroimaging; neurootology; neurosurgery.

Publication types

  • Case Reports
  • Systematic Review

MeSH terms

  • Adult
  • Brain Neoplasms*
  • Epilepsy, Temporal Lobe* / diagnostic imaging
  • Epilepsy, Temporal Lobe* / etiology
  • Epilepsy, Temporal Lobe* / surgery
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Neoplasm Recurrence, Local
  • Temporal Lobe / diagnostic imaging
  • Temporal Lobe / surgery
  • Wakefulness
  • Young Adult