Lechevalier B, Rossa Y, Eustache F, Schupp C, Boner L, Bazin C
Rev Neurol (Paris). 1984;140(3):190-201.
A 33-year-old woman had developed cortical deafness with profound initial deafness lasting for eleven months after pneumococcal meningitis ten years previously. CT scan demonstrated bilateral temporal lobe lesions, predominantly on the left side where it extended into the adjacent parietal and frontal lobes. Audiometry suggested integrity of the internal ear and brain stem. Early auditory evoked potentials were present, while potentials of moderate latency and delayed potentials were abolished. Neuropsychological investigations demonstrated total absence of spoken language, contrasting with conservation of written language, though with agrammatism and an impossibility of identifying non-verbal noises, spoken language, and music. The patient could not identify rhythms, pitch, melodies or the different types of music. The musical quality of sound stimuli and musical pleasure were, however spared as shown by recognition of tape recorded sound stimuli with written denomination and designation of images in multiple choice tests. The relations between auditory agnosia, "pure" verbal deafness and cortical deafness are discussed. Reported cases are reviewed and an attempt is made to demonstrate the existence of several levels in the integration of musical stimuli, the most elementary of which could be the perception of the musical quality of sounds, as was the case in the present patient.
一名33岁女性在十年前患肺炎球菌性脑膜炎后出现皮质聋，最初严重耳聋持续了11个月。CT扫描显示双侧颞叶病变，主要在左侧，病变延伸至相邻的顶叶和额叶。听力测试表明内耳和脑干完整。早期听觉诱发电位存在，而中度潜伏期电位和延迟电位消失。神经心理学调查显示完全没有口语，与之形成对比的是书面语言保留，但存在语法错误，且无法识别非语言声音、口语和音乐。患者无法识别节奏、音高、旋律或不同类型的音乐。然而，通过在多项选择题测试中识别带有书面名称的录音声音刺激和指定图像，可以看出声音刺激的音乐品质和音乐愉悦感得以保留。本文讨论了听觉失认症、“纯”言语性聋和皮质聋之间的关系。回顾了已报道的病例，并试图证明在音乐刺激整合中存在几个层次，其中最基本的层次可能是对声音音乐品质的感知，本病例就是如此。
