Computed tomography scan of brain revealed bilateral acute infarcts in both temporal lobes with haemorrhagic transformation on the left side ( Figure 1). His pure tone audiometry showed bilateral profound sensorineural hearing loss (in Figure 3). He was subsequently seen by an ENT surgeon whose assessment showed normal auricles and tympanic membranes. Electrocardiogram showed normal sinus rhythm with ischemic changes in the anterior leads. Random blood sugar was 326 mg/dl with an HbA1C of 11.1 g/dl. There were no signs of meningeal irritation.īlood routine investigations showed normal hemogram. Cranial nerves and sensorimotor system were within normal limits. He followed written commands, repeating written words or sentences. On examination he was conscious but gave inappropriate response to commands. There was no history of fever, headache, vomiting, cranial nerve dysfunction, weakness of limbs, or sensory abnormalities. They felt he was speaking abnormally, repeating his own words and also without any stimulus.

After recovery from postictal state, bystanders noticed that he had difficulty in hearing. A 58-year-old male, a shopkeeper from Calicut, with past history of diabetes mellitus and ischemic heart disease for 12 years' duration was admitted with a new onset seizure episode.

Secondary auditory cortex function