depression auditory hallucination hearing music

Whereas verbal auditory hallucinations have been associated with adverse childhood events, 8 this case raises the possibility of trauma as a contributing factor in the development of musical hallucinations later in life. 4,5 Multiple etiologies can contribute to the development of musical hallucinations 2,6,7 ( Table 1), with otologic causes being the most common predisposing factor. Musical hallucinations are more common in women and older individuals (aged > 60 y). She had suboptimal response with combined interventions of medication and therapy. She was advised to utilize hearing aids and encouraged to use behavioral interventions including distraction techniques and minimization of social isolation. Several medications such as quetiapine, carbamazepine, and divalproex were trialed but discontinued due to poor tolerability, with quetiapine causing worsening of musical hallucinations. The hallucinations gradually worsened over time and included voices of her grandson abusing her great-grandson. The initial abrupt emergence of musical hallucinations 1 to 2 years prior to her current admission was not in the immediate aftermath of the development of hearing impairment.

She reported musical hallucinations associated with adverse childhood events ranging from background soft music to continuous repetitive songs in her great grandson’s voice. Neurologic examination was unremarkable except for preexisting chronic, bilateral, asymmetric sensorineural hearing impairment.

3 Neuroimaging (computed tomography and magnetic resonance imaging ) and electroencephalography detected no clinically significant abnormalities. She scored 27/30 on the Montreal Cognitive Assessment. No significant cognitive deficits were observed. She was concerned about her great grandchild possibly being neglected at home amid an environment of substance abuse and family conflict. She had a history of physical and emotional abuse by her mother and other caregivers in an orphanage in early childhood. Her psychiatric history included unspecified anxiety disorder treated with sertraline 50 mg/d. Case ReportĪn 83-year-old woman with past medical history of hypertension was admitted to the internal medicine service for exacerbation of chronic obstructive pulmonary disease. 2 We report a unique case of a patient with chronic hearing impairment who presented with musical hallucinations related to adverse childhood events. 1 The pathophysiologic mechanism of musical hallucinations is not clearly understood but may include otologic, neurologic, psychiatric, and iatrogenic causes. Musical hallucinations are a rare nonverbal, complex subtype of auditory hallucinations, also known as Oliver Sacks syndrome and auditory Charles Bonnet syndrome.

Depression auditory hallucination hearing music