Another case, which studies a 74-year-old woman, described her symptoms as music that would play in short verses of patriotic and children's songs.
[3] According to Sanchez et al. 2011, there have been suggestions that pontine lesions could alter the central auditory system's function, causing hypoacusis and musical hallucinations.
[8][9] A case study by Janakiraman et al. 2006, revealed a 93‑year‑old woman with major depressive disorder who experienced musical hallucinations while treated with electroconvulsive therapy (ECT).
Investigators found that the patient's depression symptoms were inversely related to her hallucinations and primarily stemmed from the ECT treatment.
The patient had no known abnormalities in hearing, suggesting that musical hallucinations could arise from a variety of sources including psychiatric illnesses.
[3] There have also been several findings of acute musical hallucinations in patients with dorsal pons lesions post-stroke and encephalitis potentially due to disruption of connections between the sensory cortex and reticular formation.
[3] In a specific case studied by Williams et al. 2008, a patient who received a left temporal lobectomy in order to treat epilepsy was diagnosed with musical hallucinations post-surgery.
The patient also had multiple additional risk factors that could have accounted for the hallucinations including mild neuropsychiatric dysfunction and tinnitus.
Some of the drugs that have been found to relate to musical hallucinations include salicylates, benzodiazepines, pentoxifylline, propranolol, clomipramine, amphetamine, quinine, imipramine, a phenothiazine, carbamazepine, marijuana, paracetamol, phenytoin, procaine, and alcohol.
[3] In a case study by Gondim et al. 2010, a seventy–seven-year-old woman with Parkinson's disease (PD) was administered amantadine after a year of various other antiparkinsonian treatments.
Although the case wasn't specific to intoxication, it leads to the idea that persons with PD who are treated with certain drugs can experience musical hallucinations.
[14] In summary, musical hallucinations can be separated into five categories according to their cause: hypoacusis, psychiatric disorders, brain lesions, epilepsy, and substance use.
Overall, psychiatric disorders and neurological disease lead to hallucinations, but certain factors, such as age and gender play a role in heightening the causation.
[8][17][18] Oliver Sacks' patient, Mrs. O'C, reported being in an "ocean of sound" despite being in a quiet room due to a small thrombosis or infarction in her right temporal lobe.
"[19] Researchers found that patients with musical hallucinations respond well to the drug Donepezil, making it another potential treatment for the condition.
Donepezil, which belongs to a class of medication called acetylcholinesterase inhibitors, is most commonly used to treat dementia in patients with Alzheimer's disease.
The study concluded that musical hallucinations were more likely to be seen in elderly women affected by deafness or brain disease than in individuals with no psychiatric illness at all.
Although no statistical analyses were performed, the authors stated that deafness was the most strongly related factor in musical hallucinations and that there was a female predominance, which could entail a genetic component.