# Bilateral tinnitus associated with a diffuse astrocytoma of Heschl’s gyrus: a case report and review of literature

## TL;DR

A rare case of bilateral tinnitus and hemi-paraesthesia caused by a brain tumor in Heschl’s Gyrus is reported, highlighting the need for brain imaging in similar cases.

## Contribution

This case report adds to the limited literature on glial neoplasms involving Heschl’s Gyrus and their atypical auditory symptoms.

## Key findings

- Bilateral tinnitus and hemi-paraesthesia were linked to a diffuse astrocytoma in Heschl’s Gyrus.
- Symptoms were likely caused by seizure activity affecting the auditory and somatosensory cortex.
- Brain imaging is recommended for patients with unexplained bilateral tinnitus and sensory symptoms.

## Abstract

Auditory processing is initiated within the primary auditory cortex, concealed within the sylvian fissure bilaterally on a collection of gyri described as Heschl’s Gyrus (HG). Glial neoplasms localized to or involving HG are rare. The main symptoms of these tumours are complex partial seizures characterized by auditory features. Here, we describe an unusual case of bilateral tinnitus and hemi-paraesthesia associated with a HG diffuse astrocytoma. Bilateral tinnitus secondary to intrinsic brain tumours is atypical. Bilateral tinnitus is frequently observed in patients with noise-induced hearing loss, presbycusis, ototoxic medication, and metabolic and psychiatric disease. In the case we present, the synchronous sensory and auditory symptoms are likely due to seizure activity affecting the primary auditory and somatosensory cortex. In a patient presenting with chronic, bilateral tinnitus with no known underlying otologic disease which is associated with hemi-body paraesthesia, we would advocate for consideration of brain imaging to exclude pathology in HG.