Because the hallucinations often appeared to be reenactments of perceptions, Penfield concluded that electrical stimulation could activate engrams of prior experience. These occur most commonly with acute lesions involving the pontine tegmentum.Ĭanadian neurosurgeon Wilder Penfield (1891–1976) and his associates stimulated the exposed cerebral cortex of patients with uncontrollable neurologic seizures ( 49 48).Īuditory hallucinations occurred only with stimulation of or near the temporal lobe cortex. Auditory hallucinations associated with damage to brainstem structures involved in the central auditory pathways arise from release mechanisms and, consequently, tend to be prolonged and occur in association with central auditory processing disorders, including central hearing loss and impaired sound localization. ![]() ![]() Partial seizures may cause auditory hallucinations either in isolation during the awake state as a simple partial seizure, or as an aura (ie, the beginning of a symptom sequence leading to impairment of consciousness or a generalized seizure).Those resulting from irritative processes (usually seizures) are typically brief (seconds or minutes), whereas those resulting from release mechanisms are typically prolonged (days to months). Auditory hallucinations associated with lesions of the central nervous system may result from irritative or release processes.Auditory hallucinations associated with lesions of the central nervous system may be simple (as with subjective tinnitus) or complex (voices or music).Consequently, this article excludes various other conditions that can produce auditory hallucinations, including, for example, subjective tinnitus, objective tinnitus, and auditory hallucinations due to psychiatric disease (eg, schizophrenia, mania, psychotic depression, etc.), migraine, dementia, delirium or other acute encephalopathies, hallucinogens, or sensory deprivation. This article describes the various types and locations of central nervous system lesions that can produce auditory hallucinations, either on a “release” or an “irritative” basis.
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