![]() ![]() Hearing aids were ineffective and he received a hybrid cochlear implant.Īfter switching it on, the background tinnitus became louder and within half an hour he started to hear familiar musical sounds. Joe reported on a 61-year-old male with a long history of noise-induced deafness and tinnitus. While most cases involve females in the age range of 60-80 years with presbyacusis, Aizenberg described a 33-year-old female with pre-existent right tympanic membrane damage and bilateral decline of 30-50 dB in the high-frequency ranges (3000-7000), compatible with a conductive defect caused by phonal trauma. There are different causes that lead to the loss of hearing resulting in musical hallucinations. The (auditory) sensory impairment triggers the brain to compensate for the deafferentation by lowering the threshold for excitation and creating meaningful signals out of noise. In the group with hypoacusis, the main hypothesis on its origin is that the music is a by-product of deafferentation, similarly to tinnitus. In clinical practice, patients often have a combination of causes. Medication or intoxication was the cause in 8.3%, epilepsy accounted for 5.5% of the cases, and in 1.3% the aetiology was unclear. In an unpublished summary of 218 cases – where the most likely aetiology was recorded – 45.9% had hypoacusis, leaving psychiatric diagnosis (27.1%) and focal brain lesions (11.9%) far behind. “Evers and Ellger have described five main aetiological groups comprising of hypoacusis, brain lesions, epilepsy, psychiatric disorders and intoxications”Įvers and Ellger have described five main aetiological groups comprising of hypoacusis, brain lesions, epilepsy, psychiatric disorders and intoxications. People can develop secondary sleep disturbances, low mood, anxiety and delusions, sometimes even leading to suicidal thoughts. Some people find the music amusing or comforting, whilst others are annoyed or distracted by it, or may suffer deeply. Patients can hear different genres, ranging from songs heard in childhood, to songs played in church, Christmas songs, classical music, national anthems, music played in TV commercials and modern music (i.e., pop songs). ![]() ![]() They seem more common in women and older people. Many people don’t seem to mention musical hallucinations unless asked. One study found a point prevalence of 0.16% in a general hospital setting and another one, a rate of up to 20% among psychiatric patients in an outpatient clinic. Since most of these are case reports, prevalence figures are hard to come by. There are more than 400 scientific publications on musical hallucinations. Musical hallucinations can sometimes evolve from tinnitus or accompany it. The sound can be so real that patients confuse it with actual music and can go looking for its source initially, which is in contrast to earworms, i.e., songs and jingles that get stuck in the head but are never confused with actual music. They are described as hearing music without an external source to produce the sound. Musical hallucinations are fascinating phenomena that can present to many different specialties, such as audiology, ENT, neurology and psychiatry. Drs Lauw, Blom and Coebergh review the current literature on musical hallucinations and give some pointers for those suffering this condition. Many of us will have been stuck with an ‘earworm’ for a day but consider how it would be to have that earworm stuck on repeat, possibly forever. ![]()
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