The clinical characteristics of 53 sporadic (S) cases of idiopathic partial epilepsy with auditory features (IPEAF) were analyzed and compared to previously reported familial (F) cases of autosomal dominant partial epilepsy with auditory features (ADPEAF) in a study at the University of Bologna, Italy. Age at onset of seizures ranged from 6 to 39 years (aver. 19 years), and the most common type were secondarily generalized (79%). Auditory auras occurred alone (53%) or were associated with visual, psychic or aphasic symptoms. Most auditory auras were simple hallucinations of sound, like hissing, buzzing and vibration. Forty percent described complex, well-formed acoustic symptoms, like music or human voices. Loss of hearing was reported in 25%. Symptoms could be lateralized to one ear in 28% and were bilateral in 15%.. Sudden noise, a flushing toilet or answering the phone triggered the aura in 5 patients. The EEG was epileptiform in 18 (34%), and showed temporal slowing in 27 (51%). NMR scans in 47 and CT in 6 were normal except for minor asymmetries of ventricles in 6. Seizures were controlled in 51%, but tended to recur after drug withdrawal. The clinical characteristics of S and F patients were similar in age at onset, seizure frequency and response to therapy. Unlike cases of ADPEAF, mutations in LG11/epitempin exons were absent and the family history was negative in IPEAF. IPEAF is a form of temporal lobe epilepsy closely related to ADPEAF, and the majority of cases have a benign course. [1]

COMMENT. IPEAF is a benign form of temporal lobe epilepsy without structural brain lesion or known cause. The authors attach the term ‘idiopathic’ because they consider some unrecognized genetic factor might play a role in etiology. The authors are to be commended on their historical review of auditory seizures that includes the early references of Holmes (1927), Lennox (1960), Penfield (1951), and Currie (1971). Interest in auditory partial epilepsy has been renewed following the report of a syndrome of autosomal dominant partial epilepsy with auditory features (Ottman et al, 1995).