2011, there have been suggestions that pontine lesions could alter the central auditory system's function causing hypoacusis and musical hallucinations. Those Who Hear Music: Three Cases on Musical Hallucinations, National Hospital of Sri Lanka, Sri Lanka, Faculty of Medicine, University of Colombo, Sri Lanka, 29-year-old female garment factory worker, One song she first heard and liked as a young girl 50 years ago, 3-4 current songs with no special preference, chanting “pirith” (a form of religious sermon), Initially low amplitude but became louder with time causing distress. She reported that 2 males are living inside her body controlling her activities. Some of the drugs that have been found to relate to musical hallucinations include salicylates, benzodiazepines, pentoxifylline, propranolol, clomipramine, amphetamine, quinine, imipramine, a phenothiazine, carbamazepine, marijuana, paracetamol, phenytoin, procaine, and alcohol. This was observed in one of our patients we reported as she heard songs by a popular singer she used to listen as a young girl. Explore symptoms, inheritance, genetics of this condition. One year following the intervention, she remains asymptomatic. After treatment, Mrs. O'C was relinquished of her musical experience but said that, "I do miss the old songs. Sacks also reported another elderly woman, Mrs. O'M, who had a mild case of deafness and reported hearing musical pieces. [3] According to Sanchez et al. The authors declare that there are no conflicts of interest regarding the publication of this paper. An 86-year-old lady complained of being persecuted by her neighbours for 3-month duration. The sounds were slow and rhythmic in nature. However, it is an interesting phenomenon which can occur in various organic and psychiatric disorders. Moreover, had been widowed for a while and had no signs of psychiatric disorders. according to Blom and Coebergh, Bipolar Disorder and personality disorders can increase the chances of musical hallucinations. Musical hallucination (MH) is the experience of hearing music when none is being played. 2008, a patient who received a left temporal lobectomy in order to treat epilepsy was diagnosed with musical hallucinations post-surgery. 2006, revealed a 93‑year‑old woman with major depressive disorder who experienced musical hallucinations while treated with electroconvulsive therapy (ECT). For the case of an 84 year old widow who complained of hearing sounds, she described her symptoms as pleasant, but also sought for treatment because she felt distracted. Metacognitive beliefs, beliefs about voices and affective symptoms in patients with severe auditory verbal hallucinations. The main use of the drug is to treat dementia in patients, but is primarily a cholinesterase inhibitor. While there is no set form of treatment, research has discovered medications and alternative therapies to be successful in alleviating the hallucinations. However, she did suffer from hypertension, hyperthyroidism, and osteoporosis. Table 1 shows the comparison of the characteristics of the three patients. The music that played over her head was similar to the hymns and songs sung at her own wedding. The number of cases with auditory Charles Bonnet Syndrome with hearing impairment has been reported. As opposed to reported cases she enjoyed her chanting and regretted the disappearing following treatments. With the music, pleasant memories resurfaced and she enjoyed experience of hallucinations as a result. Researchers found that patients respond well to the drug. The prognosis depends on the aetiology. Auditory hallucination, also known as paracusia, is a type of hallucinations where the patient perceives sounds like voices, music etc. It was like being given back a forgotten bit of my childhood again." Moreover, through further analysis the patient had a medical history of hypertension, hyperlipidemia, and atrial fibrillations. She found great relief with the voices and believed that she has achieved a higher spiritual status. Most people find their musical hallucinations obtrusive, and wish to be rid of them, while others welcome them. She was admitted with the complaints of severe headache of sudden onset and was found to have intraventricular and intracranial haemorrhages. Listening to music had positive effects on positive symptoms and the quality of life of patients with auditory hallucination. General anesthesia has also been associated with musical hallucinations. Musical hallucinations are known to have heterogeneous aetiologies. There is a paucity of evidence on treatment of musical hallucinations. There is a deficiency of literature on this fascinating phenomenon. in 2015 the majority of the patients with psychiatric causality for musical hallucinations had depression followed by bipolar affective disorder. Hence, Keshavan et al., in 1992, argued that musical hallucinations are due to memories that patient find difficult to unlearn [5]. Overall, with few adverse effects, research has found that donepezil is an effective and safe choice of treatment. Since music is a human universal, Reference Brown 37 present in all cultures, its recognition and production may be a hardwired neural element activated during MHs. [3] There have also been several findings of acute musical hallucinations in patients with dorsal pons lesions post-stroke and encephalitis potentially due to disruption of connections between the sensory cortex and reticular formation. This was observed in two of the patients we reported. Sign up here as a reviewer to help fast-track new submissions. Slow, rhythmic chanting of the same amplitude. According to Bauman, auditory hallucinations can range from simple sounds such as “ringing, roaring, buzzing, hissing, etc.,” to complex sounds, such as music, singing and “voices that sound vaguely like a radio broadcast playing in another room.” Those with MES tend to experience hearing sounds in the complex range. Gertz, “Treatment of musical hallucinosis with acetylcholinesterase inhibitors,”. Evers and Ellgers compiled a significant portion of musical hallucination articles, case studies etc. Musical hallucinations can occur in people who are physically and mentally healthy, and for them, there is no known cause. Although no statistical analyses were performed, the authors stated that deafness was the most strongly related factor in musical hallucinations and that there was a female predominance, which could entail a genetic component. She reported gradual hearing impairment for 2 years. Musical hallucinations, like actual musical sounds, are associated with activity in an extensive network of interconnected brain areas. [3][22][4], "Musical Hallucinations Treated with Acetylcholinesterase Inhibitors", "Minds on replay: musical hallucinations and their relationship to neurological disease", "Musical Hallucinations in a Patient with Presbycusis: A Case Report", "Those Who Hear Music: Three Cases on Musical Hallucinations", "Musical hallucinations associated with acquired deafness", "Musical hallucination associated with hearing loss", "ECT associated musical hallucinations in an elderly patient: a case report", "Musical hallucinations: review of treatment effects", "Donepezil: MedlinePlus Drug Information", "Donepezil in the treatment of musical hallucinations", https://en.wikipedia.org/w/index.php?title=Musical_hallucinations&oldid=997409818, Symptoms and signs: Cognition, perception, emotional state and behaviour, Creative Commons Attribution-ShareAlike License, This page was last edited on 31 December 2020, at 10:43. Her cognitive functions were normal. The patient also had multiple additional risk factors that could have accounted for the hallucinations including mild neuropsychiatric dysfunction and tinnitus. The music persisted until three days after cessation of the drug. Musical hallucination carries no diagnostic significance on its own. Hearing sound that no-one else can hear is quite common, but the experience is normally of a simple sound such as a buzzing, ringing, or sizzling: this is known as tinnitus. She had no neurological deficits in the physical examination. There have been successful therapies in single cases that have ameliorated the hallucinations. [3] Musical hallucinations can occur in people who are physically and mentally healthy, and for them, there is no known cause. Auditory hallucinations occur in 8% to 13% of patients with PD and are generally accompanied by visual hallucinations. In a previously reported case in Sri Lanka by Weerasundara et al., 2013, a patient heard music that was played in the wedding day 50 years ago [4]. Her consciousness was clear and she was oriented in time, place, and person. Tendency to experience auditory hallucinations was assessed using the 5-item LSHS-R (McCarthy-Jones & Fernyhough, 2011; revised from Morrison et al., 2000) (e.g., I hear people call my name and find that nobody has done so She heard persistent voices chanting “pirith” (a form of religious sermon) for a duration of 2 years. An auditory hallucination, or paracusia, is a form of hallucination that involves perceiving sounds without auditory stimulus. Yasira Doluweera, Chathurie Suraweera, "Those Who Hear Music: Three Cases on Musical Hallucinations", Case Reports in Psychiatry, vol. One of the patients in this series had an intraventricular and intracranial bleeding. 2010, a seventy–seven-year-old woman with Parkinson's disease (PD) was administered amantadine after a year of various other antiparkinsonian treatments. Auditory Hallucinations - An Audio Representation - YouTube Musical hallucinations are a form of auditory hallucinations, in which patients hear songs, instrumental music or tunes, even though no such music is actually playing. There were impairments in her short-term memory and long-term memory along with frontal lobar impairment. In line with these results, listening to music may be recommended to cope with auditory hallucinations and [16] However, the first scientific description of the disorder was reported in the early 1900s. Hypoacusis is one of five etiologies of musical hallucinations, and is the most common in the case studies reviewed by Evers and Ellgers. Auditory musical hallucinations (AMHs) occur in psychiatric disease, 1,2 ictal states of complex partial seizures, 3-5 abnormalities in the auditory cortex, 6 thalamic infarcts, subarachnoid hemorrhage, 7 tumors of the brain stem, 8 1 Therefore, the two terms may be better differentiated by considering etiology. Evers and Ellgers compiled a significant portion of musical hallucination articles, case studies etc. 1 Auditory musical hallucinations (AMHs) are rare Some people going through auditory hallucinations may also hear music or hear something that seems as though it is coming from another room. Hearing impairment, psychosis, organic conditions including epilepsy, brain tumours, head injury, encephalitis, multiple sclerosis, and substance intoxication are among the commonest causes. and were able to categorize five major etiologies: After analyzing 46 cases, Berrios found a female predominance of 80% in women over the age of 60. Read a full report on the clinical features of Lewy Body Dementia (LBD) auditory hallucinations and the possible mechanisms they arise in patients. [9] They believed that the external environment influences the auditory hallucinations, showing worsening of symptoms in quieter environments than in noisier ones. the patient hears sounds which do not exist and are imaginary. Structural brain lesions can cause musical hallucinations [6]. A musical hallucination is a type of auditory hallucination where music is perceived without an external source. [10], According to Evers and Ellgers, some other major psychiatric disorders that contribute to musical hallucinations include schizophrenia and depression. 2018, Article ID 9361382, 3 pages, 2018. https://doi.org/10.1155/2018/9361382, 1National Hospital of Sri Lanka, Sri Lanka, 2Faculty of Medicine, University of Colombo, Sri Lanka. Autosomal dominant partial epilepsy with auditory features (ADPEAF) is an uncommon form of epilepsy that runs in families. In a case study by Gondim et al. The goal of this medication is provide patients with a better quality of life. The patient who heard religious phrases in the form of “pirith” found comfort in her music and regretted getting treatment when her symptoms improved with treatments. [8][9], A case study by Janakiraman et al. Researchers suspected her hearing loss as a factor for developing the hallucinations. Positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) show that musical hallucinations activate a wide variety of areas in the brain including the following: auditory areas, motor cortex, visual areas, basal ganglia, brainstem, pons, tegmentum, cerebellum, hippocampi, amygdala, and peripheral auditory system. One year following the initiation of treatments she remains symptom free. Many cases of focal brain lesions had comorbidity with hearing impairment (see hypoacusis), epileptic activity and intoxication. Significant improvement of symptoms and the patient regretted the disappearance of hallucinations, S. Evers and T. Ellger, “The clinical spectrum of musical hallucinations,”, G. E. Berrios, “Musical hallucinations. A 29-year-old female was referred by the neurosurgical team as she complained of hearing music for one-week duration. However, the music became very disturbing as it got louder with time. Some patients who have schizophrenia experience musical hallucinations due to their ongoing psychosis, but there are some cases that do so without psychosis. She had no hearing impairment. Investigators found that the patient's depression symptoms were inversely related to her hallucinations and primarily stemmed from the ECT treatment. Some of these successes include drugs such as neuroleptics, antidepressants, and certain anticonvulsive drugs. Auditory hallucination An auditory hallucination is the experience of hearing spontaneous imaginary noises. [3] In a specific case studied by Williams et al. It is observed in primary psychotic illness, in sensory deprivation states like hearing impairment and organic psychosis. A musical hallucination is a type of auditory hallucination where music is perceived without an external source. In 73 individual cases reviewed by Evers and Ellger, 57 patients heard tunes that were familiar, while 5 heard unfamiliar tunes. However, other two patients with intracranial haemorrhage and schizophrenia improved with antipsychotics. Epileptic brain activity in musical hallucinations originates in the left or right temporal lobe. Hearing of music started one week following the surgery. When she was treated with anticonvulsive medications, her musical hallucinations ceased but when asked if she missed them, she said "Not on your life. [3] Sanchez reported that some authors have suggested that the use of hearing aids may improve musical hallucination symptoms. After a complete course of ECT, her hallucinations dissipated, also suggesting that they can be acute. However, according to Bentall's definition of AHs, perceptions of tones, clicks, noise, etc. Each person will hear something different, but outsiders will not be able to hear Oftentimes, cases are commonly found in the elderly, but a 29-year-old female reported hearing music for one week. Although the case wasn't specific to intoxication, it leads to the idea that persons with PD who are treated with certain drugs can experience musical hallucinations.[14]. Through further analysis, researchers found that due the unexpected origin of the hallucinations, there is no clear diagnosis or treatments to carry out. Case studies report successful management of musical hallucinations using antidepressants, antipsychotics, and cognitive enhancers depending on the aetiology [11]. Berrios concluded that confirmed diagnoses of deafness, ear disease, brain disease, advanced age and drug use are all important factors in the development of musical hallucinations. She was hearing familiar songs in increased volume with distorted sounds. One year following the initiation of treatments she has no symptoms. Auditory hallucinations persist in up to 50% of patients, despite their receiving pharmacological therapies, underscoring the need for additional interventions to address these symptoms. [7] Most people find their musical hallucinations obtrusive, and wish to be rid of them, while others welcome them. Prior to her hallucinations, the patient had undergone surgery for intraventricular and intracranial hemorrhages, following her recover, she mentioned the onset of hallucinations followed by headaches. Another case, which studies a 74-year-old woman, described her symptoms as music that would play in short verses of patriotic and children's songs. [8][17][18] Oliver Sacks' patient, Mrs. O'C, reported being in an "ocean of sound" despite being in a quiet room due to a small thrombosis or infarction in her right temporal lobe. Written informed consent was obtained from all three patients. Auditory hallucinations mostly consisted of voices (51%), music (36%), and doorbells or telephones (24%). This personal significance and enjoyable nature of the hallucinations have cast doubt about the true nature of the musical hallucinations. In a survey by Golden et al. The occurrence, past and present, of auditory hallucinations has been studied in 121 consecutive patients with Parkinson’s disease attending a movement disorders clinic. Most auditory hallucinations are a repetitive human voice. Comparison of the characteristics of the three patients. 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