We report a case of auditory disturbance in an adult female that developed after starting lacosamide treatment for epilepsy. While carbamazepine is known to change auditory pitch perception in some patients, that has not been previously reported as a side effect of lacosamide administration. In our description of pitch perception deficit associated with lacosamide, we outline features seen in our patient and compare our findings with those of previous reports describing carbamazepine-associated auditory disturbance.