Auditory+Agnosia

Bilateral Lesions (cortical deafness)
-Generalized auditory agnosia: words and non-linguistic sounds.

Unilateral Right Temporal Lobe Lesion
Loses the capability to correctly discern: -Environmental (e.g. birds singing, doors closing, keys jangling) and acoustically related sounds -Music -Emotional-prosodic speech (social-emotional agnosia, phonagnosia) -The voices of loved ones or friends correctly -What others may be implying -Emotional and contextual cues - variables such as sincerity or mirthful intonation -Due to emotional auditory deficits a host of behavioral difficulties may arise

Example
May complain that his wife no longer loves him, and that he knows this from the sound of her voice. May also notice that the voices of friends and family sound in some manner different, which, when coupled with difficulty discerning nuances such as humor and friendliness may lead to the development of paranoia and what appears to be delusional thinking. Unless appropriately diagnosed, the problem will feed likely upon and reinforce itself and grow more severe.

Diagnostic Notes
Unilateral right temporal damage is less likely to come to the attention of a physician unless accompanied by secondary emotional difficulties. Most individuals with this disorder, being agnosic, would not know that they have a problem and thus would not complain. If they are their families notice (e.g. patient does not respond to a knock on the door) the likelihood is that the problem will be attributed to faulty hearing or even forgetfulness.

It is important to note that rather than completely agnosic or word deaf, patients may suffer from only partial deficits. In these isntances they may seem to be hard of hearing, frequently misinterpret what is said to them, and/or slowly develop related emotional difficulties

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