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Cortical Deafness Due to Ischaemic Strokes in Both Temporal Lobes

  • Lachowska, Magdalena (Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw) ;
  • Pastuszka, Agnieszka (Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw) ;
  • Sokolowski, Jacek (Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw) ;
  • Szczudlik, Piotr (Department of Neurology, Medical University of Warsaw) ;
  • Niemczyk, Kazimierz (Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw)
  • Received : 2020.06.02
  • Accepted : 2020.09.15
  • Published : 2021.07.20

Abstract

Cortical deafness is a clinical rarity whereby a patient is unresponsive to all types of sounds despite the preserved integrity of the peripheral hearing organs. In this study, we present a patient who suddenly lost his hearing following ischaemic infarcts in both temporal lobes with no other neurological deficits. The CT confirmed damage to the primary auditory cortex (Heschl's gyrus) of both hemispheres. Initially, the patient was unresponsive to all sounds, however, he regained some of the auditory abilities during 10 months follow up. Pure tone threshold improvement from complete deafness to the level of moderate hearing loss in the right ear and severe in the left was observed in pure tone audiometry. Otoacoustic emissions, auditory brainstem responses, and acoustic reflex findings showed normal results. The middle and late latency potential results confirmed objectively the improvement of the patient's hearing, however, after 10 months still, they were somewhat compromised on both sides. In speech audiometry, there was no comprehension of spoken words neither at 3 nor at 10 months. The absent mismatch negativity confirmed above mentioned comprehension deficit. The extensive auditory electrophysiological testing presented in this study contributes to the understanding of the neural and functional changes in cortical deafness. It presents the evolution of changes after ischaemic cerebrovascular event expressed as auditory evoked potentials starting from short through middle and long latency and ending with event-related potentials and supported by neuroimaging.

Keywords

References

  1. Silva J, Sousa M, Mestre S, Nzwalo I, Nzwalo H. Cortical deafness of following bilateral temporal lobe stroke. J Stroke Cerebrovasc Dis 2020;29:104827. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104827
  2. Musiek FE, Chermak GD, Cone B. Central deafness: a review of past and current perspectives. Int J Audiol 2019;58:605-17. https://doi.org/10.1080/14992027.2019.1606458
  3. Ozdamar O, Kraus N, Curry F. Auditory brain stem and middle latency responses in a patient with cortical deafness. Electroencephalogr Clin Neurophysiol 1982;53:224-30. https://doi.org/10.1016/0013-4694(82)90027-X
  4. Kaga K, Shindo M, Tanaka Y. Central auditory information processing in patients with bilateral auditory cortex lesions. Acta Otolaryngol Suppl 1997;532:77-82. https://doi.org/10.3109/00016489709126148
  5. Musiek FE, Lee WW. Neuroanatomical correlates to central deafness. Scand Audiol Suppl 1998;49:18-25. https://doi.org/10.1080/010503998420612
  6. Garde MM, Cowey A. "Deaf hearing": unacknowledged detection of auditory stimuli in a patient with cerebral deafness. Cortex 2000;36:71-80. https://doi.org/10.1016/S0010-9452(08)70837-2
  7. Brody RM, Nicholas BD, Wolf MJ, Marcinkevich PB, Artz GJ. Cortical deafness: a case report and review of the literature. Otol Neurotol 2013;34:1226-9. https://doi.org/10.1097/MAO.0b013e31829763c4
  8. Polster MR, Rose SB. Disorders of auditory processing: evidence for modularity in audition. Cortex 1998;34:47-65. https://doi.org/10.1016/S0010-9452(08)70736-6
  9. Pinard M, Chertkow H, Black S, Peretz I. A case study of pure word deafness: modularity in auditory processing? Neurocase 2002;8:40-55. https://doi.org/10.1093/neucas/8.1.40
  10. Koohi N, Vickers D, Chandrashekar H, Tsang B, Werring D, Bamiou DE. Auditory rehabilitation after stroke: treatment of auditory processing disorders in stroke patients with personal frequency-modulated (FM) systems. Disabil Rehabil 2017;39:586-93. https://doi.org/10.3109/09638288.2016.1152608
  11. Engelien A, Huber W, Silbersweig D, Stern E, Frith CD, Doring W, et al. The neural correlates of 'deaf-hearing' in man: conscious sensory awareness enabled by attentional modulation. Brain 2000;123 Pt 3:532-45. https://doi.org/10.1093/brain/123.3.532
  12. Musiek FE, Charette L, Morse D, Baran JA. Central deafness associated with a midbrain lesion. J Am Acad Audiol 2004;15:133-51; quiz 172-3. https://doi.org/10.3766/jaaa.15.2.4
  13. Narayanan S, Majeed KA, Subramaniam G, Narayanan A, Navaf KM. A case of cortical deafness due to bilateral heschl gyrus infarct. Case Rep Med 2017;2017:6816748.
  14. Cassidy JM, Cramer SC. Spontaneous and therapeutic-induced mechanisms of functional recovery after stroke. Transl Stroke Res 2017;8:33-46. https://doi.org/10.1007/s12975-016-0467-5
  15. Hordacre B, Moezzi B, Ridding MC. Neuroplasticity and network connectivity of the motor cortex following stroke: a transcranial direct current stimulation study. Hum Brain Mapp 2018;39:3326-39. https://doi.org/10.1002/hbm.24079
  16. Kang N, Summers JJ, Cauraugh JH. Non-invasive brain stimulation improves paretic limb force production: a systematic review and meta-analysis. Brain Stimul 2016;9:662-70. https://doi.org/10.1016/j.brs.2016.05.005
  17. Glick H, Sharma A. Cross-modal plasticity in developmental and age-related hearing loss: Clinical implications. Hear Res 2017;343:191-201. https://doi.org/10.1016/j.heares.2016.08.012
  18. Ding H, Qin W, Liang M, Ming D, Wan B, Li Q, et al. Cross-modal activation of auditory regions during visuo-spatial working memory in early deafness. Brain 2015;138:2750-65. https://doi.org/10.1093/brain/awv165