PALINACUSIS

Timothy C. Hain, MD and Marcello Cherchi, M.D., Ph.D. Page last modified: January 9, 2008

Palinacusis, or "auditory perseveration", is a rare condition in which sounds repeat even after they are inaudible. It is related to another rare neurological condition - -palinopsia, in which visual images repeat or cause trails.

CAUSES OF PALINACUSIS.

All reported causes of palinacusis have involved brain -- temporal lobe -- dysfunction. The temporal lobe of the brain contains auditory cortex -- brain tissue that processes sound.

LITERATURE REVIEW

There have only been 3 published papers (as of 2007) concerning palinacusis.

Patterson et al (1988) reported a a 50-year-old woman presented with nausea, vomiting, and global dysphasia, followed by two generalized seizures. Examination was otherwise normal, and computed tomography showed a small area of enhancement near the left sylvian fissure; there was a left temporal focus on the electroencephalogram. Treatment with phenytoin was instituted, and speech improved, with residual fluent dysphasia. Three days postictally, the patient complained of "echoing voices" in her right ear. Words or fragments of sentences recently uttered by the patient or others were perceived to recur unaltered for minutes to hours. Sounds other than speech were also affected. One week later the voices had disappeared, but a ticking sound was present; this also faded subsequently. The palinacousis never recurred; the patient was later found to have a Grade IV astrocytoma of the left temporal lobe, which caused her demise 8 months later.

Auzou et al (1995) reported another case in a 78-year-old patient with a left temporo parietal astrocytoma. The patient complained of "echoing voice" in his right ear. Palinacousis was associated with sensitive partial seizures. Neuropsychological investigations revealed hemianacusia with normal performance for phonological discrimination and verbal repetition. They suggested that these preserved abilities allowed emergence of palinacousis.

CONCLUSIONS

Palinacusis is a rare central auditory symptom. Most reported cases have been associated with temporal lobe lesions and seizures. It seems likely to us that this symptom is due to a loss of normal inhibition, or due to irritibility of audiotory cortex. Brain imaging and and EEG may be productive investigations.

References:

• Bekény G, Péter A.Meningocerebral cysticercosis with auditory perseveration (palinacusis).Confin Neurol. 1973;35(4):236-47.
• Patterson, Tomlinson FH, Stuart GG. Neurosurgery. 1988 Jun;22(6 Pt 1):1088-90. Palinacousis: a case report.
• Auzou P, Hannequin D, Cochin JP, Girard C, Augustin P. Rev Neurol (Paris). [Palinacousis with hemianacusia caused by left temporal lesion] [Article in French] 1995 Feb;151(2):129-31.