Auditory auras in patients with postencephalitic epilepsy: case series.

Many previously healthy patients who present with new seizures or status epilepticus appear to have encephalitis for which no specific pathogen is identified. A significant portion of these patients develop epilepsy. We describe five patients with adult-onset, medically intractable, postencephalitic epilepsy characterized by auditory auras ranging from unformed buzzing to structured language. Auras of any type were common among patients with postencephalitic epilepsy in our referral database: 62% experienced at least one type of aura. The proportion of postencephalitic patients with auditory auras (38%), which may reflect lateral temporal cortical pathology, was higher than that of other adult epilepsy populations. Although no pathogen was identified in four of the five cases, we suggest that the pathophysiology of viral encephalitides may share common targets in the temporal lobes, especially the superior temporal gyrus and surrounding areas, which may account for possibly increased occurrence of auditory auras in this population.