Seizures can cause auditory hallucinations, defined as hearing sounds or voices when no external source is present. A seizure is fundamentally a temporary event of abnormal, excessive, or synchronous electrical activity in the brain. When this electrical disturbance occurs in the brain regions responsible for processing sound, it can directly trigger the perception of noise. These auditory experiences are a specific neurological symptom that offers important clues about where the seizure begins.
Linking Specific Seizure Types to Auditory Output
The neurological mechanism behind auditory hallucinations in epilepsy is strongly associated with the brain’s temporal lobe. This area contains the auditory cortex, the primary center for processing sound information. When a seizure originates here, it causes a brief period of intense electrical overactivity that misfires the neurons responsible for hearing.
Auditory hallucinations are most commonly a symptom of focal seizures, where abnormal electrical activity starts in one specific area. If the seizure discharge begins in or spreads to the lateral part of the temporal lobe, it produces an auditory sensation. This abnormal electrical discharge essentially hijacks the brain’s sound processing center, making the person perceive sounds that are not real. The auditory hallucination can occur as a seizure in isolation or as an aura, the beginning of a seizure event.
The Characteristics of Seizure-Related Sounds
The sounds experienced during a seizure can vary widely. Simple auditory phenomena are often described as non-verbal noises, such as buzzing, ringing, clicking, humming, or a rushing sound. These elementary sounds are sometimes mistaken for common tinnitus, but they are sudden and brief, directly correlating with the seizure’s onset.
Complex auditory hallucinations involve hearing more organized and recognizable sounds. These may include distinct voices, specific music, or environmental noises like a ringing telephone. In some cases, the patient may even experience receptive aphasia, a sudden inability to understand language, along with the auditory symptoms. Unlike hallucinations associated with psychiatric disorders, seizure-induced sounds are usually very short in duration, and the person remains aware that the sound is not actually present.
Clinical Investigation of Auditory Symptoms
A person reporting auditory symptoms suspected to be seizure-related will undergo investigation by a neurologist. The first step involves taking a detailed patient history, focusing on the exact nature, timing, and duration of the perceived sounds. Determining if the sound immediately precedes a larger seizure event or occurs in isolation helps localize the seizure origin.
Key diagnostic tools confirm a seizure disorder and pinpoint the source of the electrical misfiring. An Electroencephalogram (EEG) is the most common test, measuring the brain’s electrical activity using electrodes placed on the scalp. The EEG helps capture the abnormal electrical discharges characteristic of epilepsy, particularly in the temporal regions. Neuroimaging, such as MRI or CT scans, is also performed to check for structural abnormalities in the temporal lobe. Finding a structural cause, like scar tissue or a small lesion, can indicate the origin of the seizure focus.
Therapeutic Approaches for Seizure-Induced Hallucinations
Since the auditory hallucination is a symptom of the underlying seizure, the primary goal of treatment is to achieve seizure control. This is most often accomplished through Anti-Epileptic Drugs (AEDs), which stabilize the electrical activity of nerve cells in the brain. The specific choice of AED may be tailored based on the focal nature of the seizure, targeting the abnormal firing in the temporal lobe.
Controlling the seizures often stops the auditory hallucinations from recurring, as the irritative electrical process is suppressed. In cases where medication is not effective and the seizure focus is clearly identified, typically due to a structural abnormality, surgical intervention may be considered. This surgery aims to remove the specific area of the temporal lobe where the seizures originate, offering a potential cure for the epilepsy and eliminating the auditory symptoms.