Objectives:
To explore auditory hallucinations of the musical type in the context of a clinical case.

Background:
Musical hallucinations are complex auditory hallucinations that usually present as songs, melodies or tunes popular in the patient’s culture. Musical hallucinations have a prevalence of of approximately 0.16%, but they are likely underreported. They are more likely to occur in elderly women with impaired hearing. They are frequently associated with severe psychiatric illnesses, cerebral lesions, temporal lobe epilepsy and other neurological disorders. They can also be a side-effect of some medications. The treatment depends on the underlying cause.

Materials and Methods:
Literature review and description of a clinical case.

Results and Conclusions:
A 74 year old woman was evaluated in the emergency room with depressed mood and insomnia as chief complaints. Anamnesis revealed uncontrollable church music inside her head for over three months. The musical hallucinations were mood incongruent. The woman had diabetes, hypertension, and  atrial fibrillation. She also had mild hypoacusia. She was treated with an SSRI and low dose sedative antipsychotic medication. When reviewed in consultation, she was euthymic and no longer appalled by what she kept listening in a milder way. She said she had found comfort in the rosary and she was no longer bothered by “god’s music”. Imagiological findings revealed a left temporal lobe focal lesion secondary to ischemia. There were no other findings in diagnostic tests including EEG. Psychotic depression was discarded by the follow-up. Musical hallucinations could not be better explained than by the focal lesion.

MUSICAL HALLUCINATIONS IN A PATIENT WITH MULTIPLE CARDIOVASCULAR RISK FACTORS