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Neurology (Expert Forum)
Musical Hallucinations
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Musical Hallucinations
by marta, Aug 19, 2000 12:00AM
For the last four weeks or so I have heard what sounds like a male choir harmonizing in my head. The voices are faint but definitely alto. It sounds like music played quietly during a Mass or Catholic funeral service. Recently patriotic music and Christmas music is heard I havethis 24/7 during waking hours, the only time I cannot hear it is if the TV is turned up loud or if I am on the telephone. I do have late stage, neurological Lyme Disease, MRI's have shown three lesions on my brain. A PET Scan performed in Feb 2000 before this began,showed significant hypometabolism in temporal lobes bilaterly, also bilateral hypometabolism in the parietal lobes. I should also mention I have had hearing loss since 1985 and have worn a hearing aid since then. I am 50 years old. I also have had a few instances of crashing noises in my head. I know I need to see a neurologist for this, but mine is out of town till the
28th of this month, and my family doctor is not available till the 26th. I did find a Reuter's article about this dated August 7th of this year, here is what it said:
Musical hallucinations linked to brain disorders
NEW YORK, Aug 07 (Reuters Health) - Stroke often robs the ability to speak
or to move an arm or leg. For a handful of people, stroke or other brain
disorders have another effect--"musical hallucinations" in which patients
hear a constant melody. Now doctors have zeroed in on the part of the brain
responsible for the bizarre symptom.
Lesions in a part of the brain stem called the dorsal pons seem to be behind
the 11 reported cases of musical hallucinations, researchers report in the
August issue of Neurology. Dr. Eva Schielke and her colleagues at University
Hospital Charite in Berlin, Germany, describe the case of one 57-year-old
man whose bout with meningitis caused him to hear a boys' choir singing folk
tunes.
The patient only became aware of the hallucinations several hours after they
began, and, according to Schielke's team, he thought he was hearing a
"celebration" in the schoolyard near the hospital. His musical interludes
lasted for 5 weeks.
Only 10 other such cases have been reported. When musical hallucinations
occur, it is usually among psychiatric patients or older people who have
gone deaf.
Schielke told Reuters Health that among people who lose their hearing, this
long-term sensory deprivation leads to a "release of musical memories." In
the case of her patient and the 10 others, however, lesions on the dorsal
pons seem to "interrupt" certain nerve fibers in the brain stem.
No one knows why these patients hear music in particular, according to
Schielke. And while some of them are "mildly annoyed" by the hallucinations,
others find it a "pleasant distraction," she said.
SOURCE: Neurology 2000;55:454-455.
This really does not give me much information, other than it appears this is very rare, but no suggestions on what to do about this phenomena, any suggestions would be appreciated, or if you have encountered this condition before, I would like to hear about it. I would also like to know if you know how long this will last? Since my neurologist is on vacation till the 28th, and I am at a loss as to where to turn till then.
Marta
28th of this month, and my family doctor is not available till the 26th. I did find a Reuter's article about this dated August 7th of this year, here is what it said:
Musical hallucinations linked to brain disorders
NEW YORK, Aug 07 (Reuters Health) - Stroke often robs the ability to speak
or to move an arm or leg. For a handful of people, stroke or other brain
disorders have another effect--"musical hallucinations" in which patients
hear a constant melody. Now doctors have zeroed in on the part of the brain
responsible for the bizarre symptom.
Lesions in a part of the brain stem called the dorsal pons seem to be behind
the 11 reported cases of musical hallucinations, researchers report in the
August issue of Neurology. Dr. Eva Schielke and her colleagues at University
Hospital Charite in Berlin, Germany, describe the case of one 57-year-old
man whose bout with meningitis caused him to hear a boys' choir singing folk
tunes.
The patient only became aware of the hallucinations several hours after they
began, and, according to Schielke's team, he thought he was hearing a
"celebration" in the schoolyard near the hospital. His musical interludes
lasted for 5 weeks.
Only 10 other such cases have been reported. When musical hallucinations
occur, it is usually among psychiatric patients or older people who have
gone deaf.
Schielke told Reuters Health that among people who lose their hearing, this
long-term sensory deprivation leads to a "release of musical memories." In
the case of her patient and the 10 others, however, lesions on the dorsal
pons seem to "interrupt" certain nerve fibers in the brain stem.
No one knows why these patients hear music in particular, according to
Schielke. And while some of them are "mildly annoyed" by the hallucinations,
others find it a "pleasant distraction," she said.
SOURCE: Neurology 2000;55:454-455.
This really does not give me much information, other than it appears this is very rare, but no suggestions on what to do about this phenomena, any suggestions would be appreciated, or if you have encountered this condition before, I would like to hear about it. I would also like to know if you know how long this will last? Since my neurologist is on vacation till the 28th, and I am at a loss as to where to turn till then.
Marta
Doctor's Answer
by CCF Neuro[P] MD, RPS, Aug 19, 2000 12:00AM
Dear Marta:
Thank you for your enlightening posting. I have only read the article and have not seen a patient with musical hallucinations. So, as you, I do not know how long this will go on for. However, if these hallucinations are like other senses, they should resolve overtime but how long I can not tell you. It may be many months. If the hallucinations are caused by seizures (not indicated by what you are telling me) then they may never go away. I have not seen or read about a musical aura, so I doubt the latter hypothesis.
Sorry that I am not much help.
Sincerely,
CCF Neuro MD
Thank you for your enlightening posting. I have only read the article and have not seen a patient with musical hallucinations. So, as you, I do not know how long this will go on for. However, if these hallucinations are like other senses, they should resolve overtime but how long I can not tell you. It may be many months. If the hallucinations are caused by seizures (not indicated by what you are telling me) then they may never go away. I have not seen or read about a musical aura, so I doubt the latter hypothesis.
Sorry that I am not much help.
Sincerely,
CCF Neuro MD
Thanks so much for your quick reply. I don't believe this is seizure related either. I am sorry to hear that this is a rare phenomena (as indicated in the article). I had an awful time trying to locate information about this on the internet as I did not know what to call it. Finally after many days of searching I found a reference to it on the Oliver Sacks web site message boards. I believe Dr Sacks mentioned a patient in his book "The Man who Mistook his wife for a Hat" who had this occur, I need to check out the book at the library to see what he says about it. While I had read his book years ago, I don't recall this story. Again, thanks for replying, I am quite anxious for my doctor to return from vacation, I believe if I call him to discuss this by phone, he may agree to see me immediately.
Marta
Talking about Oliver Sacks, I have the book here before me.
Look for 'Reminiscences' or the story of Mrs O.C.
It is too complex to give the explanation here but I know from myself as well that the temporal lobe is mainly responsible for musical hallucinations.
Talking about Oliver Sacks, I have the book here before me.
Look for 'Reminiscences' or the story of Mrs O.C.
It is too complex to give the explanation here but I know from myself as well that the temporal lobe is mainly responsible for musical hallucinations.
I haven't made it to the library yet, but someone else sent me this information posted below. To your knowledge is this the extent of Sack's writing about the phenomena, or is there more?
http://www.uni.edu/walsh/caserep.html
Reminiscence
David Sivesind
Source: Sacks, Oliver (1995). The Man Who Mistook His
Wife For a Hat. 125-142.
Patient Background: Mrs. O'C, besides some deafness, was
a relatively healthy woman
in her eighties living in an old people's home. One night
she had been dreaming of her
childhood in Ireland. When she woke, she continued
hearing the Irish music, although no
radio was playing. She thought the music might be
collecting like radio signals in her
dental fillings. This was not the case. She consulted a
nurse, an otologist, and a
psychiatrist, none of whom could find an explanation.
Finally, the author, a neurologist,
was consulted in the case. Mrs. O'M, also a woman in her
eighties at the same home,
later came to the author with similar concerns. The woman
complained of hearing several
songs. Sometimes, she heard several songs at once. Her
songs began one day when she
was grating parsnips in the kitchen. She heard several
church hymns in rapid succession.
Mrs. O'M expressed considerably greater distress from
hearing the music than Mrs.
O'C.
Behavioral Change: Continuing from the night described
above, Mrs. O'C continued to
experience an "ocean of sound" both during sleep and
waking hours. The songs were all
Irish songs from her childhood. As the days progressed,
the music continued to become
louder and more prominent. Tests showed that she was not
experiencing any deafness or
loss of hearing. She was bright and alert, but was
described as appearing remote and self
absorbed. All indications were that Mrs. O'C was a
completely normal 88 year old
woman the day before she began hearing the music. After
four months, the songs were
gone. Mrs. O'C was relieved that the songs were gone, but
expressed missing the songs.
She felt that the experience had brought back a piece of
her childhood that was lost
before the incident. She felt that the experience,
although unnerving, had been a sort of
healing process for her. Mrs. O'M was a similar case with
slight differences. She had
heard sound in her head for four years before telling
anyone of her symptoms. She was
somewhat deaf. She heard music in her head, sometimes
with ringing, hissing or rumbling
sounds. She sometimes heard distant voices, occasionally
many at once. Mrs. O'M's
experience was significantly more rattling. The songs she
heard did not hold any special
meaning for her. Thinking of the songs would bring them
into her mind. Avoidance of
thinking of the songs would bring them into her mind. She
came to hate the songs. She
could hear several songs or sounds at the same time. Her
condition progressed and
worsened over the next year. At times, the music became
so loud that she was unable to
hear conversation. Mrs. O'M was finally treated
successfully by the use of
anticonvulsants. She did not miss the songs. Nervous
System Changes: The concern
expressed by both patients was dubbed a sort of 'Musical
Epilepsy'. It is believed that
the epileptic seizures occurred in the "reminiscence"
portion of the brain. EEG's
confirmed that both patients had experienced temporal
lobe seizures during the time that
they experienced the music in their heads. The songs
experienced by both women did
appear to have some psychological significance to them.
While it is obvious that Mrs.
O'C was experiencing songs she had recalled from a
pleasant childhood, it was only late
in treatment that Mrs. O'M revealed that she was apt to
hum the songs she later heard in
her head before she began to hear them in her head. Mrs.
O'C's symptoms disappeared
without physiological treatment. Her experience appears
to have had the effect of a
psychological healing, what the author dubbed
"nostalgia". Mrs. O'M was successfully
treated by anticonvulsants which halted her temporal lobe
seizures.
Family or Physician Reflections: There was no mention of
reactions from the families
of either of the women. However, the author/neurologist
expressed personal insights into
the cases. He commented that the cases could be
considered at the same time both from
a physiological and psychoanalytic framework. He saw both
women's experiences as
"reminiscence". That is, an experience that was both
meaningful physically and
nostalgically, the workings of experiential memory.
Reaction to Case: It is very interesting that very
similar neurological cases can be
experienced so differently by individual patients. While
the neurologist was able to
determine the physiological cause of the songs
experienced by both women, it is intriguing
that the psychological importance of the songs was
directly related to how the women
experienced their symptoms.
Me again,
I cannot relate to the women in this article, I cannot control the music nor was I thinking nostalgically of my days in church as a child in Catholic school. And, I am only 50 years old, these women appear to be in their 80's. I also wonder if these are indeed seizures since I am already on 1800mg of Neurontin daily for nerve pain and have been for some time now. Also, in addition to the choir music I am hearing Patriotic music, Xmas songs, and old songs from my childhood, "Tammy" and "Tonight" from movies I saw as a child.
I will be relieved when they stop, and hope they do very soon.
Do you think if I wrote to Dr Sacks that he would respond?
Thanks for your post.
Marta
First of all, I'm not a doctor so I cannot really advise you much more. I had the book in front of me so I decided to react.
'Reminiscences' is about 15 pages in O.Sacks's book.(at least in my own language as I live in Belgium).
Concerning your age compared with that of the two older ladies in the book, I don't think this is relevant here because O.Sacks writes much more amazing stories about people of all ages.
Even in his book "Migraine" he mentions a few auditory aura.
As to writing Dr Sacks I don't know but why not trying ????