She was started on quetiapine 25 mg and was gradually titrated up to 150mg for which she responded. A Noncontrast CT (NCCT) brain following the onset of musical hallucinations revealed no abnormalities. She had no neurological deficits in the physical examination. There were impairments in her short-term memory and long-term memory along with frontal lobar impairment. Her consciousness was clear and she was oriented in time, place, and person. She had no hallucinations of any other modalities and nor there were any delusions. She was hearing familiar songs in increased volume with distorted sounds. Hearing of music started one week following the surgery. Following the surgical evacuation of the haemorrhages she made a full recovery. She was admitted with the complaints of severe headache of sudden onset and was found to have intraventricular and intracranial haemorrhages. Case TwoĪ 29-year-old female was referred by the neurosurgical team as she complained of hearing music for one-week duration. One year following the intervention, she remains asymptomatic. The consultant otolaryngologist recommended her hearing aids after which the hallucinations disappeared completely without any psychotropics. Her mental state examination was normal with no other psychotic phenomena or cognitive impairment. In neurological examination bilateral hearing impairment was detected which was confirmed to be sensorineural auditory impairment on audiography. She reported gradual hearing impairment for 2 years. However, the music became very disturbing as it got louder with time. Initially it was not disturbing and she enjoyed it. She identified them as vocals with the background music of a popular singer whom she adored as a young girl. Case OneĪ 78-year-old widow presented with hearing of songs for a duration of six months. It is observed in primary psychotic illness, in sensory deprivation states like hearing impairment and organic psychosis. A musical hallucination is a type of auditory hallucination where music is perceived without an external source. Musical hallucinations are rare but fascinating phenomena in psychiatry which have not been explored adequately. The case series also highlights the fact that different aetiologies should be managed differently for the patients to be benefited. We report three patients who presented with musical hallucinations due to different aetiologies, namely, due to hearing impairment, intracerebral haemorrhage, and schizophrenia. However, it is an interesting phenomenon which can occur in various organic and psychiatric disorders. Musical hallucination carries no diagnostic significance on its own.
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