Auditory hallucinations and migraine of possible brainstem origin

• DOI: 10.1007/s10194-011-0355-z
• Publication Date: 2011-06-03T12:49:16Z
• Authors: Y. L. Lo; S. Hameed; H. Rumpel; L. L. Chan
• Keywords: Pons; Gliosis; Fluid-attenuated inversion recovery; Midbrain reticular formation; Tegmentum; Auditory hallucination

Concurrence of migraine and hallucinations is extremely rare the underlying mechanism poorly understood. We report a 22-year-old man with associated auditory hallucinations. Concurrent psychotic illness has been excluded. Brain MR scans showed stable, patchy FLAIR hyperintensity over posterolateral aspect left cerebral peduncle, just below level red nucleus. This was felt to represent an area gliosis based on interval stability 19 months. There absence features for aggressive neoplasms, such as lesional high cellular turnover (choline/NAA ratio >1.0) or blood volume advanced imaging spectroscopy dynamic perfusion MR. EEG brainstem evoked potentials were unremarkable. To our knowledge, there are no reports date similar in adult patients, well MRI lesions. The peduncular lesion could previous migrainous infarct, possible analogy can be drawn from descriptions hallucinosis. Brainstem lesions, particularly midbrain pons, have rarely this condition. It postulated that damage ascending reticular systems thalamocortical circuitry may contribute its pathogenesis.