Suppression of verbal hallucinations and changes in regional cerebral blood flow after intravenous lidocaine: a case report.
Plewnia C, Bischof F, Reimold M
Department of Psychiatry and Psychotherapy, University of Tuebingen, Osianderstrasse
24, D-72076 Tuebingen, Germany.
Simple and complex auditory phantom-perceptions such as tinnitus and musical
hallucinations occur predominantly in elderly subjects and are often associated
with hearing impairment.
Isolated verbal hallucinations without other
psychotic features are rare.
It has been shown that an intravenous (i.v.)
injectionof lidocaine can transiently suppress tinnitus.
Here we present
the case of a 74 year old left-handed women with severely distressing,
continuous verbal auditory hallucinations without other psychotic features.
I.v. injections of 100 mg lidocaine but not saline resulted in substantial
transient suppressions of the hallucinations for several hours.
[(15)O]H(2)O positron-emission tomography (PET) decreased regional cerebral
blood flow associated with reduced perception of voices was found in
the right angular and supramarginal gyrus, right inferior frontal gyrus,
orbitofronal cortex and in major parts of the cingulated cortex.
data suggest to further investigate the clinical relevance of i.v. lidocaine
in patients with therapy-resistant verbal hallucinations, support the
notion of common pathophysiological mechanisms in different forms of auditory
phantom-perception and demonstrate the feasibility of a new strategy forimaging
studies on auditory hallucinations.
Prog Neuropsychopharmacol Biol Psychiatry. 2007 Jan 30;31(1):301-303.