Contralateral hyperacusis in unilateral pontine hemorrhage

Abstract

Hyperacusis, an increased sensitivity to auditory stimulation,1 may occur in patients with peripheral auditory system dysfunction, migraine, depression, and certain infectious diseases. However, hyperacusis is a rare manifestation of CNS lesions.2 Previous studies have reported paracusia (altered perception of loudness, timbre, or pitch) and palinacousis (perseveration of aural sensation) after medial geniculate body hemorrhage,3 auditory hallucination due to pontine hemorrhage,4 and bilateral hyperacusis due to caudal tectal hemorrhage.5 We report a unique patient presenting with unilateral hyperacusis due to a pontine hemorrhage. ### Case report. A 51-year-old hypertensive woman suddenly felt that environmental sounds were heard louder in her left ear than before. She said that “I feel as if an amplifier is inserted into my left ear hole.” At the same time, a machinery, “MRI noise-like” sound was heard in her left ear. She also had unpleasant tingling sensation in her left hemibody. On admission to a six-bed room of our hospital, she could not tolerate the noise, especially a loud, high pitched female voice, and requested us to move her to a more quiet two-bed room. She could not sleep in the left decubitus position, partly because tactile auricle stimulation aggravated the hyperacusis and tinnitus (allodynia) …