Meningocerebral Cysticercosis with Auditory Perseveration (Palinacusis)

Abstract

The CSF of a female patient with temporal epilepsy contained up to 38% eosinophil cells, 3–4% plasma cells, a ‘mulberry cell’ among them. Agar-gel electrophoresis of the cerebrospinal fluid indicated a greatly increased Γ-globulin content (48.4%), containing four subfractions, of which the Γ₂-fraction dominated (22.3%). There were palpable nodules under the skin and the muscles. X-ray pictures showed innumerable calcified shadows. The great number of nodules found on muscle biopsy were identified as Cysticercus cysts. The patient experienced peculiar auditory illusions: genuine auditory sensations recurred and persevered for a long period of time. This auditory illusion has not been described before and may be called acoustic perseveration, or palinacusis. The simultaneous occurrence of auditory perseveration and hallucinations points to their common pathomechanism. The neurological symptoms were presumably caused by left temporofrontally localized meningocerebral cysticercosis.

Palinacousis as Discontinuation Symptom after Antipsychotic Treatment in a Patient with First-Episode Schizophrenia

“…Therefore, a real auditory perception (voices, music, noises) is followed by a marginally distinguishable, variously persisting illusion of the same content after the initial acoustic stimulus is no longer available [1] . It is a rare phenomenon in focal brain lesions in the temporal lobe and the medial geniculate nucleus, in epilepsy, migraine, hypacusis, alcohol dependency as well as in various organic mental disorders and schizophrenia [2][3][4][5][6][7][8][9][10][11] . A co-occurrence with musical hallucinations is possible [10][11] .…”