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Abstract Details

Auditory Hallucinations Associated with Primary Headache Attacks: A Descriptive Case Series and Literature Review
Headache
P01 - (-)
091
Isolated observations have documented a rare association of migraine with auditory hallucinations. Unlike visual, somatosensory, language, motor, and brainstem symptoms, paracusias in the acute headache attack setting are not a recognized aura symptom by the International Classification of Headache Disorders (ICHD), and no systematic review has addressed this association.
We retrospectively studied patients experiencing paracusias associated with headache attacks at our center and reported in the literature.
We encountered 15 patients (our center=7, literature=8), 53% of whom were female. For those patients where enough data permitted applying an ICHD diagnosis, 92% had migraine and 8% had new daily-persistent headache. 53% of total patients suffered from typical migraine aura. Regarding hallucination content, the most common sound was distinct human voices (n=8, 53%), followed by crickets (n=2, 13%), ringing bells (n=2, 13%), general white noise (n=2, 13%), and repetitive beeping (n=1, 7%). Regarding timing, 80% experienced hallucinations concurrent with headache, with 20% hearing sounds prior to attacks. Paracusia duration was frequently <1 hour (n=5, 63%), but occasionally lasted 4-5 hours (n=1) or the duration of the headache (n=1). Most patients (n=10, 67%) had either a current or previous psychiatric disorder, mostly depression (60%, n=6). In all patients, the course of headache and paracusias was congruent. Improvement in both symptoms occurred both spontaneously and often (53%) when headache prophylaxis was prescribed, which included propranolol (n=4), topiramate (n=3) and amitriptyline (n=3).
Paracusias are an uncommon co-occurrence with headache disorders, most commonly migraine, and usually feature the sound of human voices. The timing of the perceived sounds and the very high prevalence of depression may suggest that paracusias are not a form of migraine aura, and other mechanisms should be considered.
Authors/Disclosures
Eli E. Miller
PRESENTER 		No disclosure on file
Brian Grosberg, MD (Hartford HealthCare Headache Center) Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Theranica. Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie. Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Linpharma pharmaceuticals. Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Amgen. Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Theranica . Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biohaven. Dr. Grosberg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie. Dr. Grosberg has stock in Theranica. The institution of Dr. Grosberg has received research support from Theranica. The institution of Dr. Grosberg has received research support from Amgen. The institution of Dr. Grosberg has received research support from Abbvie. The institution of Dr. Grosberg has received research support from Eli Lilly. The institution of Dr. Grosberg has received research support from Teva. The institution of Dr. Grosberg has received research support from Neurolief. Dr. Grosberg has received publishing royalties from a publication relating to health care.
Sara C. Crystal, MD (NY Headache Center) Dr. Crystal has received personal compensation for serving as an employee of Thirty Madison. Dr. Crystal has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biohaven. Dr. Crystal has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Allergan.
Matthew S. Robbins, MD, FAAN (Weill Cornell Medicine) Dr. Robbins has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer. Dr. Robbins has received publishing royalties from a publication relating to health care. Dr. Robbins has a non-compensated relationship as a Board of Directors member, 好色先生 Program speaker with American Headache Society that is relevant to AAN interests or activities. Dr. Robbins has a non-compensated relationship as a Board of Directors member, 好色先生 Program speaker with New York State Neurological Society that is relevant to AAN interests or activities. Dr. Robbins has a non-compensated relationship as a Editorial Board Member with Continuum, 好色先生 that is relevant to AAN interests or activities.
Gavin Giovannoni, MD (QMUL) Dr. Giovannoni has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck KGaA. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche-Genentech. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Moderna. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sandoz. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Astoria Biologica. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Zenas. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Giovannoni has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Medscape.