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Updated: Jan 10, 2026

Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study
Published on: August 15, 2025
A case of acquired amusia and misophonia following right temporal resection
Emily R Dappen1, Joel I Berger2, Amy M Belfi3
1Department of Neurosurgery, The University of Iowa, Iowa City, IA 52242, USA; Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA 52242, USA.
Background:
Our perception of the auditory world allows us to enjoy the richness of music and communicate effectively with others. These everyday processes are disrupted in conditions such as amusia, an inability to perceive music accurately, and misophonia, an intense emotional reaction to common sounds produced by others. We describe a case of acquired, concurrent amusia and misophonia in a 21-year-old right-handed woman following a right posterior insula, posterior temporal, supramarginal cortex, and sensory cortex resection for the treatment of drug-resistant epilepsy.
Methods:
The patient participated in interviews between 4-8 months post-resection. She completed an extensive testing battery designed to characterize her acquired deficits and increased sensitivity to misophonic triggers.
Results:
Assessments revealed significant deficits in several domains of music processing, including scale, key, contour, and interval. High levels of misophonia symptom severity and impairment indicated clinically elevated misophonia. The patient performed within the normal range for speech-in-babble perception and music reward despite self-reporting pertinent impairments. Performance on tonal beat perception, musical imagery, memory, and sophistication measures were average.
Conclusions:
The results from the extensive testing battery highlight the contribution of the resected regions to normal music perception. Additionally, this case represents the first reported instance of acquired misophonia.

