Neurologic, audiologic, and electrophysiologic sequelae of bilateral temporal lobe lesions

A 67-year-old woman with demonstrated intact peripheral and brain-stem auditory pathways presented with sudden deafness secondary to sequential bilateral temporal lobe infarcts. Initial examination revealed no behavioral response to sounds and a mild Wernicke's aphasia. Hearing gradually returned but auditory agnosia persists. Changes seen on the computed tomographic scan and the middle latency auditory evoked response over a seven-month period were analyzed and suggest that the peak component of the middle latency response arises from Heschl's gyrus.