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Complex auditory musical hallucinations with ambivalent feelings
Hugo Canas-Simião1, Sandra Teles Nascimento2, João Reis2
1Department of Psychiatry, Centro Hospitalar de Lisboa Ocidental EPE, Lisbon, Portugal hugo.simiao@gmail.com.
BMJ Case Reports
|November 12, 2021
Summary
This case study details a 78-year-old woman experiencing complex musical hallucinations (MH) alongside cognitive dysfunction and delusions. The findings highlight the heterogeneous causes of MH, including hearing loss and vascular factors.
Area of Science:
- Geriatric Psychiatry
- Neurology
- Ophthalmology
Background:
- Musical hallucinations (MH) are rare auditory phenomena.
- Commonly associated with hearing impairment, cognitive dysfunction, and vascular risk factors.
Observation:
- A 78-year-old woman with hypertension, diabetes, and hearing loss presented with cognitive dysfunction, erotomanic delusion, and complex musical hallucinations.
- Hallucinations involved a neighbor singing, bells, and conversational elements.
- Brain CT revealed hypodensities suggestive of vascular etiology.
Findings:
- The patient's complex musical hallucinations, including conversational and singing elements, are unique.
- Vascular factors may contribute to the etiology of musical hallucinations.
- The case underscores the complex interplay between hearing impairment, cognitive function, and auditory hallucinations.
Implications:
- This case expands the understanding of musical hallucination phenomenology.
- Further research is needed to fully map brain circuitry involved in musical memory and hallucinations.
- Highlights the importance of considering vascular contributions in complex auditory hallucinations.
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