Patterson M C, Tomlinson F H, Stuart G G
Department of Medicine, University of Queensland, Royal Brisbane Hospital, Australia.
Neurosurgery. 1988 Jun;22(6 Pt 1):1088-90. doi: 10.1227/00006123-198806010-00022.
Palinacousis (auditory perseveration) is a rarely reported symptom of temporal lobe dysfunction. We describe a new case. 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. The features of this case are similar to those previously reported and favor an epileptic etiology. Palinacousis should be recognized as a sign of organic temporal lobe disease and not confused with manifestations of psychotic illness.
持续性听觉现象（听觉 perseveration）是一种很少被报道的颞叶功能障碍症状。我们描述了一个新病例。一名 50 岁女性出现恶心、呕吐和完全性失语，随后发生两次全身性癫痫发作。其他检查均正常，计算机断层扫描显示左侧外侧裂附近有一小片强化区域；脑电图显示左侧颞叶有病灶。开始使用苯妥英钠治疗，言语功能有所改善，仍残留流利性失语。癫痫发作后三天，患者抱怨右耳有“回声”。患者或他人近期说出的单词或句子片段会原封不动地反复出现数分钟至数小时。非言语声音也受到影响。一周后，声音消失，但出现了滴答声；随后滴答声也逐渐消失。持续性听觉现象再也没有复发；患者后来被发现患有左侧颞叶四级星形细胞瘤，8 个月后导致其死亡。该病例的特征与先前报道的相似，支持癫痫病因。持续性听觉现象应被视为器质性颞叶疾病的体征，不应与精神疾病的表现相混淆。
