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Reply from the Authors

Dr. Gordon purports that complex auditory hallucinations (AH) are invariably peripheral (otologic) in nature, never central (neurologic). In fact, Dr. Gordon has challenged neurologists to find a case of the latter. However, careful examination of reported cases" lends considerable support to a neurologic basis for complex AH. In particular, we draw Dr. Gordon's attention to the article of Murata, et al., describing a 54-year-old Japanese man with left ear deafness since childhood. This patient experienced no AH until he presented with right sided hearing loss attributable to pontine tegmental hemorrhage. This patient's bilateral deafness was supported by audiogram. Furthermore, right BAER during his deafness and AH showed preservation of wave I only suggesting normal right cochlear function. Importantly, his AH disappeared when his right sided hearing returned; BAER also normalized. In this case, the patient's longstanding left sided deafness secondary to otologic disease was a very unlikely factor in generating AHs.