[Musical hallucinations: perpetual music]. / Alucinaciones musicales: la musica perpetua.

INTRODUCTION: Musical hallucinations are a kind of auditory hallucination that are prevalent among the non-psychiatric population, but which have rarely been reported in the neurological literature. They occur most frequently in the elderly, in females and when there is a loss of hearing, but their pathophysiology has still to be unravelled. CASE REPORTS: We report here six cases (five females and one male) of musical hallucinations diagnosed in a general neurology clinic over a time-span of five years. In five cases there was also concurrent hypoacusis, to a greater or lesser extent, and one had been triggered by pentoxifylline. In most instances, the musical content of the hallucinations had its origins in music experienced in childhood and early youth. In the cases submitted to pharmacological treatment, the response was poor. Yet, after explaining to the patients that the condition was benign and had no connection with a psychotic pathology, the degree of acceptance of the symptoms was good. CONCLUSIONS: Musical hallucinations are a little-known pathology lying on the borderline between neurology, otorhinolaryngology and psychiatry which are often wrongly linked to mental disease. It is essential to explain to patients and relatives that these symptoms are not necessarily of a psychiatric nature, and to be aware of the potential capacity of some commonly used drugs to generate them.

TITLE: Alucinaciones musicales: la musica perpetua.Introduccion. Las alucinaciones musicales son un tipo de alucinacion auditiva prevalente en la poblacion no psiquiatrica, pero escasamente comunicada en la bibliografia neurologica. Ocurren con mayor frecuencia en la poblacion anciana, del sexo femenino y con perdida de audicion, pero su fisiopatologia esta por desentrañar. Casos clinicos. Se presentan seis casos (cinco mujeres y un hombre) de alucinaciones musicales diagnosticados en una consulta de neurologia general en un lapso de tiempo de cinco años. En cinco de ellos concurria la hipoacusia en mayor o menor grado y uno estaba desencadenado por la pentoxifilina. En su mayoria, el contenido musical de las alucinaciones provenia de experiencias musicales vividas en la infancia y juventud. En los casos sometidos a tratamiento farmacologico la respuesta fue pobre; sin embargo, una vez explicada a los pacientes la benignidad del cuadro y su desvinculacion con patologia psicotica, el grado de aceptacion del sintoma fue bueno. Conclusiones. Las alucinaciones musicales son una patologia fronteriza entre la neurologia, la otorrinolaringologia y la psiquiatria poco conocida, que, con frecuencia, se vincula erroneamente a la enfermedad mental. Es fundamental explicar a pacientes y familiares el caracter no necesariamente psiquiatrico de este sintoma, asi como conocer la potencialidad que tienen algunos farmacos de uso comun para generarlo.

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