title: Auditory hallucinations associated with migraine: Case series and literature review.
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.
authors.affiliation: Albert Einstein College of Medicine, USA.
authors.forename: Eli E
authors.initials: EE
authors.lastname: Miller
authors.affiliation: Montefiore Headache Center, Department of Neurology, Albert Einstein College of Medicine, USA.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Grosberg
authors.affiliation: New York University Langone Medical Center, Department of Neurology, USA.
authors.forename: Sara C
authors.initials: SC
authors.lastname: Crystal
authors.affiliation: Montefiore Headache Center, Department of Neurology, Albert Einstein College of Medicine, USA marobbin@montefiore.org.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Robbins
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006212:Hallucinations / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D020325:Migraine with Aura / Q000175:diagnosis / Q000453:epidemiology; D012189:Retrospective Studies; D055815:Young Adult
keywords: Auditory; aura; hallucination; headache; migraine; paracusias