Musical Hallucinations Associated With Seizures Originating From an Intracranial Aneurysm

Abstract

Hallucinations are defined as sensory phenomena in the absence of external sensory stimuli. Auditory hallucinations have been shown to arise from many different intracranial lesions, but seizures manifesting as musical hallucinations triggered by unruptured intracranial aneurysms are rare. We present a case of persistent, episodic musical hallucinations associated with seizures that led to the discovery of 2 small intracranial aneurysms. Typical electroencephalographic findings for seizure activity were observed but resolved after surgical clipping of the aneurysms. Concomitantly, the patient's hallucinations resolved. The literature on musical hallucinations is reviewed.

Is musical hallucination an otological phenomenon? a review of the literature

“…Keeley et al 52 Gordon 26 Keshavan et al 43 Gordon et al 75 Kobayashi et al 63 Prommer 56 Lennox 71 Stephane et al 68 Marneros et al 73 Moore 30 Murata et al 37 Nagaratnam et al 42 Paraskevaides 55 Rennie 46 Roberts et al 41 Rozanski and Rosen 29 Schielke et al 38 Stephane and Hsu 33 Tanriverdi et al 32 Terao and Tani 72 Ukai et al 74 Wengel et al 19 Wales. From this, they computed a referral rate of one case of clinically significant MH per year, per 10 000 individuals over 65 years of age.…”

“…13 Musical Hallucination has been reported as arising from lesions of early stages of sound processing (brainstem, 36,37 pons, 38 thalamus 39 and auditory radiation), 34 and of higher-level auditory association cortices such as right temporal lobe. 40 The cause of the lesion also appears unimportant, with MH caused by intracranial aneurysms, 41 ischaemic infarction, 39 haemorrhage 37 and tumours. 42,43 Vascular pathology is likely to be overrepresented in the literature relative to clinical practise as lesions can selectively damage auditory pathways while leaving other centres intact, allowing for detailed phenomenological investigation.…”

“…The study of MH has been informative of the importance of hemispheric dominance for language in musical listening. In general, cases of MH have been associated with the right auditory cortex in musically untrained individuals, 41,64 and the left in musicians. 34 Some authors have concluded that this variation implies that language dominance is not primarily relevant for the development of MH, 65 while others propose that the cortical rearrangement arising from musical training 66 and the analytical listening style of musicians 67 shifts musical processing to the left hemisphere in this group.…”