Abstracts

Rationale: Rational: Musical Hallucinations (MH) are complex auditory hallucinations formed by hearing instrumental music, sound or songs; MH are a uncommon symptom in neurology, reported in less of 2% in patients with pharmacoresistant epilepsy. The mechanism by which such hallucinations occur remains elusive.Methods: Methods: Case report and literature review.Results: Results: A 49-year-old right-handed man with an 8-months history of musical hallucinations at his right ear, he had 3 episodes, none lasting more than 1 minute of a known melody but was unable to recall where and when, intermingled with some radio frequencies. He consulted to ER after an episode of musical hallucination followed by loss of consciousness, and forced deviation of his head and eye to the right, drooling and a generalized symmetric tonic posture with an interval of about 5 minutes with subsequent confusion for 1 hour and amnesia of the event to the right, drooling and a generalized symmetric tonic posture with an interval of about 5 minutes with posterior confusion for 1 hour and amnesia of the event. The patient has no relevant medical history, the general and neurological physical examination were unremarkable. Complementary studies with gadolinium MRI and spectroscopy showing a superior temporal gyro mass, a 24 hr video-EEG with intermittent delta and theta activity in the anterior temporal region and 8 episodes of musical hallucinations were observed. Was initiated levetiracetam 2000 mg/day. Thereafter he underwent brain surgery with resection of lesion corresponding with ganglioglioma WHO I in the pathology.Conclusions: Conclusion: MH has been related to 5 etiologic factors, hypoacusis, psychiatric disorders, focal brain lesion, epilepsy and intoxication; epilepsy accounts the 11% of causes of MH associated primary with lesions in the left temporal cortex as our patient. The MH are very rare in patients with epilepsy but could give important information about localization and perhaps lateralization, making important an adequate differentiation between MH secondary to psychiatric disorders and epilepsy for an optimal management of the patient. Bibliography Evers, S. Tanja, E. The clinical spectrum of musical hallucinations. J Neurol Sci (2004) 227; 55-65. Serino, A. Heydrich, L. Kurian, M. Spinelli, L. Seeck, M. Blanke, O. Auditory verbal hallucinations of epileptic origin. Epilepsy Behav. (2014) 31; 181-186.