Author(s): Canas-Simião, Hugo ; Nascimento, Sandra Teles ; Reis, João ; Freitas, Carina
Date: 2021
Persistent ID: http://hdl.handle.net/10400.26/38157
Origin: Serviço de Saúde da Região Autónoma da Madeira, E.P.E.
Subject(s): musical allucinations; ambivalent feelings; music feelings; cognitive dysfunction; Portugal; Madeira Island; Região Autónoma da Madeira; geriatric psychiatry; hearing loss; (CT) computed tomography
A 78-year-old woman with hypertension, diabetes mellitus type 2 and bilateral sensorineural hearing loss was referenced to geriatric psychiatry consultation. She presented cognitive dysfunction, erotomanic delusion and complex musical hallucinations (MH), described as hearing her neighbour singing a familiar church song along with bells in the background, making comments and talking to her. A computed tomography (CT) of the brain detected small right nucleocapsular and bilateral external capsules hypodensities of presumed vascular aetiology during hospitalisation. MH are a rare phenomenon with heterogeneous aetiology. Most frequently, the cause is hearing impairment; other causes include social isolation, cognitive dysfunction, vascular risk factors and medication. Studies suggest that some brain areas related to musical memory circuitry might be related and not fully mapped. Auditory verbal hallucinations with a voice that either comments, talks or sings to the patient have never been described in the literature, making this clinical case attractive.
