[A case of hysterical deafness].

A forty years old woman with hysterical deafness is reported. Chief complaints were bilateral hearing loss. Nothing particular was found in her past and family history. In 1977, on the 11th day of May, she was admitted to A city hospital because of headache and paresis of right limb. As angiography revealed an aneurysms of her anterior communicating artery, she was undertaken the surgery of clipping and coating of the aneurysms. Post-operatively, left hemiparalysis appeared and paresis of right limb developed because of spasm of right middle cerebral artery. On the 14th day of August, ventricular-peritoneal shunt's operation was performed. As soon as she recovered from postoperative coma, she complained of bilateral hearing loss. Because pure tone audiometry demonstrated complete loss of her hearing, she was referred to ENT department of Teikyo University Hospital. Findings were as follows: 1) She had a queer way of hearing because she could understand to hear limited persons' speech (her doctor and husband). 2) Pure tone audiometry showed complete loss of her hearing but the thresholds of auditory brain stem responses were 15 dB and those of slow vertex responses were 45 dB. These results suggested no lesion in cochlea and brain stem. 3) Rorschach test and sentence complete test were performed. The results of these tests suggested hysterical state or neurotic state. 4) Total intelligent quotients by WAIS were 69 which indicated borderline level. However, this value appeared to be incorrect because she was uncooperative. 5) CT scan revealed low density areas at right temporo-parietal lobes and left temporal lobe which were localized and small. Our findings suggested hysterical deafness but not auditory agnosia. During three years, she was referred to several hospitals for rehabilitation but didn't become well at all. On the third year of the onset, her husband became sick and admitted to her room of the same hospital. During that period, suddenly, she talked her hearing to improve and the pure tone audiometry demonstrated decrease in threshold. In conclusion, this event could give a final diagnosis of hysterical deafness but not auditory agnosia.