![]() An analysis of phenomenological characteristics, pharmacological triggers, and treatment effects suggests wider ramifications for understanding musical hallucinations. To account for the underlying mechanism we propose a Bayesian model involving top-down and bottom-up prediction errors within the auditory network that incorporates findings from EEG and MEG studies. The case descriptions suggest that musical hallucinations in epilepsy can be conceptualised as lying on a continuum with other auditory hallucinations, including verbal auditory hallucinations, and-notably-tinnitus. Based on the phenomenological descriptions and neurophysiological data, we distinguish four subgroups of epilepsy-related musical hallucination, comprising auras/ictal, inter-ictal and post-ictal phenomena, and phenomena related to brain stimulation. We also describe six of our own patients. Our search yielded 191 articles, which together describe 983 unique patients, with 24 detailed descriptions of musical hallucinations related to epilepsy. We, therefore, reviewed the literature, and assessed all descriptions of musical hallucinations attributed to epileptic activity. Their relation with epilepsy was first described over a century ago, but never systematically explored. doi: 10.1212/wnl.Musical hallucinations are poorly understood phenomena. Autosomal dominant partialĮpilepsy with auditory features: defining the phenotype.
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