{Reference Type}: Journal Article {Title}: Auditory hallucinations associated with migraine: Case series and literature review. {Author}: Miller EE;Grosberg BM;Crystal SC;Robbins MS; {Journal}: Cephalalgia {Volume}: 35 {Issue}: 10 {Year}: Sep 2015 {Factor}: 6.075 {DOI}: 10.1177/0333102414563088 {Abstract}: OBJECTIVE: The objective of this review is to describe auditory hallucinations (paracusias) associated with migraine attacks to yield insights into their clinical significance and pathogenesis.
BACKGROUND: Isolated observations have documented rare associations of migraine with auditory hallucinations. Unlike visual, somatosensory, language, motor, and brainstem symptoms, paracusias with acute headache attacks are not a recognized aura symptom by the International Headache Society, and no systematic review has addressed this association.
METHODS: We retrospectively studied patients experiencing paracusias associated with migraine at our center and in the literature.
RESULTS: We encountered 12 patients (our center = 5, literature = 7), 58% were female, and 75% had typical migraine aura. Hallucinations most commonly featured voices (58%), 75% experienced them during headache, and the duration was most often <1 hour (67%). No patients described visual aura evolving to paracusias. Most patients (50%) had either a current or previous psychiatric disorder, most commonly depression (67%). The course of headache and paracusias were universally congruent, including improvement with headache prophylaxis (58%).
CONCLUSIONS: Paracusias uncommonly co-occur with migraine and usually feature human voices. Their timing and high prevalence in patients with depression may suggest that paracusias are not necessarily a form of migraine aura, though could be a migraine trait symptom. Alternative mechanisms include perfusion changes in primary auditory cortex, serotonin-related ictal perceptual changes, or a release phenomenon in the setting of phonophobia with avoidance of a noisy environment.