Lancet: Listening but not understanding: a case report of speech-auditory agnosia caused by brainstem lesions

Recently, a case report published on Lancet reported a case of auditory deafness caused by a brainstem lesion:

The patient was a 57-year-old, native English-speaking male who complained of "progressive incomprehension of words for 5 weeks" despite hearing words
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• Past medical history: The patient presented with dysphagia 18 months ago due to inoperable adenocarcinoma of the esophagogastric junction, which had received chemotherapy and radiotherapy; no other relevant medical history and no previous hearing impairment
  
  

  The investigators considered the lesion to be metastatic and treated him with stereotactic radiation therapy
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  Because the patient's pure-tone audiometry abnormalities -- mild to moderate pure-tone hearing loss -- could not explain his severe speech comprehension impairment, the researchers diagnosed him as part-of-speech deafness due to compression of the inferior colliculus mass, and were able to teach the patient and his Families communicate using smartphone speech-to-text translators
  
  diagnosis

  Pure tones used in audiometry are simple sounds with no complex speech structure - rapid, unpredictable fluctuations in frequency, amplitude and time
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  The cochlea converts sound into neural signals that travel from the cochlear nucleus through the lateral thalamus to the inferior colliculus, then to the medial geniculate nucleus, and then to the auditory cortex
  
  Pure tones used in audiometry are simple sounds with no complex speech structure - rapid, unpredictable fluctuations in frequency, amplitude and time
  
  The general ability to perceive and identify the essence of any sound is known as auditory agnosia ; although patients can hear pure tones, all complex sounds lose their meaning so that they cannot recognize or understand speech, music, or ambient sounds
  
  Hearing is tested with speech, and the full bandwidth of the auditory pathway is assessed with the pure tone test
  
  Pogson JM, Halmagyi GM.
  Hearing but not understanding: word deafness from a brainstem lesion.
  Lancet.
  2022;399(10326):756.
  doi:10.
  1016/S0140-6736(22)00191-X Leave a message here