Those Who Hear Music: Three Cases on Musical Hallucinations

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Abstract

Musical hallucination carries no diagnostic significance on its own. However, it is an interesting phenomenon which can occur in various organic and psychiatric disorders. We report three patients who presented with musical hallucinations due to different aetiologies, namely, due to hearing impairment, intracerebral haemorrhage, and schizophrenia. The case series also highlights the fact that different aetiologies should be managed differently for the patients to be benefited.

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Most cited references 13

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Cerebral dominance in musicians and nonmusicians.

T G Bever, R J Chiarello (1974)

Musically experienced listeners recognize simple melodies better in the right ear than the left, while the reverse is true for naive listeners. Hence, contrary to previous reports, music perception supports the hypothesis that the left hemisphere is dominant for analytic processing and the right hemisphere for holistic processing.

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The clinical spectrum of musical hallucinations.

Stefan Evers, Tanja Ellger (2004)

Musical hallucinations are a well known although rare phenomenon in neurological and psychiatric patients. Many case reports have been published to date. However, an accepted common theory on the classification and on the pathophysiology of musical hallucinations is still missing. We analysed all cases published to date, including two own cases, with respect to their demographic and clinical features and to the possible pathomechanisms underlying the hallucinations. In total, 132 cases could be analysed statistically and separated into five groups according to their aetiology (hypacusis; psychiatric disorder; focal brain lesion; epilepsy; intoxication). There was a female preponderance of 70% and a mean age of 61.5 years. Patients with focal brain lesions were significantly younger than the other groups, the hemisphere of the lesion did not play a major role. No systematic studies on treatment are available. However, anticonvulsant and antidepressive substances were reported to be effective most consistently. The pathophysiology of musical hallucinations is discussed considering the theories of deafferentiation including the concept of auditory Charles-Bonnet syndrome, of sensory auditory deprivation, of parasitic memory, and of spontaneous activity in a cognitive network module. In conclusion, musical hallucinations are a phenomenon with heterogeneous clinical and pathophysiological backgrounds.

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Minds on replay: musical hallucinations and their relationship to neurological disease.

Erin Golden, Keith A. Josephs (2015)

The phenomenon of musical hallucinations, in which individuals perceive music in the absence of an external auditory stimulus, has been described sparingly in the literature through small case reports and series. Musical hallucinations have been linked to multiple associated conditions, including psychiatric and neurologic disease, brain lesions, drug effect, and hearing impairment. This study aimed to review the demographics of subjects with musical hallucinations and to determine the prevalence of neurological disorders, particularly neurodegenerative disease. Through the Mayo medical record, 393 subjects with musical hallucinations were identified and divided into five categories based on comorbid conditions that have been associated with musical hallucinations: neurological, psychiatric, structural, drug effect and not otherwise classifiable. Variables, including hearing impairment and the presence of visual and other auditory hallucinations, were evaluated independently in all five groups. The mean age at onset of the hallucinations was 56 years, ranging from 18 to 98 years, and 65.4% of the subjects were female. Neurological disease and focal brain lesions were found in 25% and 9% of the total subjects, respectively. Sixty-five subjects were identified with a neurodegenerative disorder, with the Lewy body disorders being the most common. Visual hallucinations were more common in the group with neurological disease compared to the psychiatric, structural, and not otherwise classifiable groups (P < 0.001), whereas auditory hallucinations were more common in the psychiatric group compared to all other groups (P < 0.001). Structural lesions associated with musical hallucinations involved both hemispheres with a preference towards the left, and all but two included the temporal lobe. Hearing impairment was common, particularly in the not otherwise classifiable category where 67.2% had documented hearing impairment, more than in any other group (P < 0.001). Those with an underlying neurodegenerative disorder or isolated hearing impairment tended to hear more persistent music, which was often religious and patriotic compared to those with a structural lesion, where more modern music was heard, and those with psychiatric disorders where music was mood-congruent. This case series shows that musical hallucinations can occur in association with a wide variety of conditions, of which neurological disease and brain lesions represent a substantial proportion, and that Lewy body disorders are the most commonly associated neurodegenerative diseases. A future prospective study would be helpful to further delineate an association between musical hallucinations and neurodegenerative disease.

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Author and article information

Contributors

Yasira Doluweera:

ORCID: http://orcid.org/0000-0003-3607-7512

Journal

Journal ID (nlm-ta): Case Rep Psychiatry

Journal ID (iso-abbrev): Case Rep Psychiatry

Journal ID (publisher-id): CRIPS

Title: Case Reports in Psychiatry

Publisher: Hindawi

ISSN (Print): 2090-682X

ISSN (Electronic): 2090-6838

Publication date Collection: 2018

Publication date (Electronic): 27 June 2018

Volume: 2018

Electronic Location Identifier: 9361382

Affiliations

¹National Hospital of Sri Lanka, Sri Lanka

²Faculty of Medicine, University of Colombo, Sri Lanka

Author notes

Academic Editor: Toshiya Inada

Author information

Yasira Doluweera http://orcid.org/0000-0003-3607-7512

Article

DOI: 10.1155/2018/9361382

PMC ID: 6040295

SO-VID: 2db74199-8133-49e3-9bcf-9ce1e20bd3e3

License:

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 6 February 2018

Date accepted : 15 April 2018

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Those Who Hear Music: Three Cases on Musical Hallucinations

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Most cited references 13

Cerebral dominance in musicians and nonmusicians.

The clinical spectrum of musical hallucinations.

Minds on replay: musical hallucinations and their relationship to neurological disease.

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