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Originally posted by bigstan:


Here is an article on this problem and Lyme disease:

Musical Hallucinations In Patients With Lyme Disease

Raphael B. Stricker, MD, Edward E. Winger, MD

South Med J 96(7):711-715, 2003. � 2003 Lippincott Williams & Wilkins


Posted 09/12/2003
Abstract and Introduction

AbstractMusical hallucinations are poorly understood auditory hallucinations that occur in patients with otologic or neurologic diseases.

We report the first cases of musical hallucinations in two patients with neurologic Lyme disease.

Both subjects were women with clinical and laboratory evidence of chronic Lyme disease, progressive neurologic dysfunction, and abnormal magnetic resonance imaging of the brain.

There was no evidence of hearing loss in either
case.

Musical hallucinations had a sudden onset and took the form of patriotic or operatic music.

The auditory hallucinations disappeared with intravenous (IV) antibiotic therapy in both patients, but the hallucinations recurred when
IV antibiotic therapy was discontinued in one case.

Response to therapy was accompanied by an increase in the CD57 lymphocyte subset in one patient, whereas recurrent hallucinations were associated with persistently low CD57
levels in the other case.


We conclude that musical hallucinations may be
associated with neurologic Lyme disease.

These auditory hallucinations appear to respond to IV antibiotic therapy.

Patients with musical hallucinations of unknown cause should be tested for infection with the Lyme disease spirochete.


Introduction Musical hallucinations are a rare form of complex auditory hallucinations characterized by repetitive and usually uncontrollable musical patterns that are unrelated to external stimuli.[1, 2]

Musical hallucinations have been associated with infectious agents, neurologic disease, psychiatric illness, and various medications.[1-8]

Although visual and vocal hallucinations
have been reported in patients with Lyme disease,[9, 10] musical hallucinations have not previously been described as a neurologic complication of this disorder.

We report the first cases of musical hallucinations in patients with neurologic Lyme disease.


Case Reports - Patient 1

Patient 1 was a 66-year-old woman with a 7-year history of Lyme disease, which was diagnosed on the basis of a tick bite, presence of an erythema migrans rash, and positive serology (enzyme-linked immunosorbent assay and Western
blot) for the spirochete Borrelia burgdorferi.

At the time of infection, the patient was living in Sonoma County, California.

Over the years, she had suffered from recurrent musculoskeletal and flu-like symptoms, and she had been treated with various oral antibiotics including doxycycline, amoxicillin, clarithromycin, and azithromycin.

She took aspirin intermittently for pain, and
she had taken a stable dose of estrogen since menopause.

She did not smoke and she drank alcohol occasionally.

Recently, she had developed progressive
fatigue, short-term memory loss, and logamnesia.

Physical examination was unremarkable, and neurologic testing confirmed poor object recall and word searching.

Cerebrospinal fluid analysis yielded a positive test for B. burgdorferi by polymerase chain reaction.

Brain magnetic resonance imaging (MRI) revealed multiple bilateral white matter lesions consistent with neurologic Lyme disease.

Rapid plasma reagin testing was negative.


The patient initially refused intravenous (IV) antibiotic therapy, and she was retreated with clarithromycin and amoxicillin.

However, after 4 weeks of this treatment she noted the sudden onset of musical hallucinations characterized by repetitive playing of "The Star-Spangled Banner."

The music was bilateral, constant, and woke her at night.

She stated that one of her earliest childhood memories was hearing patriotic music, which she did not enjoy as an adult.

Tinnitus was absent, and auditory testing (tone conduction and speech discrimination) was normal.

An electroencephalogram was normal.

She was treated with IV ceftriaxone and her musical hallucinations resolved completely over 4 weeks.

However, her memory loss and logamnesia persisted, and she continued on IV antibiotic treatment for 9 months.

The neurologic symptoms gradually resolved, and she discontinued antibiotic therapy.

A single-photon emission computed tomographic (SPECT) brain scan performed after 8 months of IV
antibiotic therapy was negative for perfusion defects.

The musical hallucinations have not recurred during 6 months of follow-up.

The patient's CD57 lymphocyte level was initially normal on oral antibiotics, and the level increased on IV antibiotic therapy (Fig. 1).

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very interesting; thx for posting this stan hugs

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