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Musical ear syndrome as a presenting symptom of Lewy body disorder

S.J. Song, D. Lee, Y.N. Kwon, T.B. Ahn (Seoul, Korea)

Meeting: 2016 International Congress

Abstract Number: 414

Keywords: Dementia with Lewy bodies (DLB), Hallucinations

Session Information

Date: Monday, June 20, 2016

Session Title: Parkinson's disease: Non-motor symptoms

Session Time: 12:30pm-2:00pm

Location: Exhibit Hall located in Hall B, Level 2

Background: Musical ear syndrome (MES) or musical hallucination is non psychological phantom sound without auditory stimulation. MES is commonly reported in old people with hearing impairment. Some patients with Lewy body disorder (LBD) had MES during the course of medical treatment. There is no de novo case with MES in LBD.

Methods: Case Reports–Case 1: A 76-year-old woman complained MES, which had begun 1 month ago after a church service. She had a 10-year history of hearing impairment of sensorineural type. The most of the songs were hymns. Neurologic examination was normal except hearing loss. Cognitive function was normal (Mini Mental Status Examination = 29) and neuropsychiatric inventory was 10/144 (auditory hallucination and anxiety). Brain MRI showed mild periventricular white matter change. Dopamine transporter PET using 18F-FPCIT showed decreased uptake of 18F-FPCIT in bilateral posterior putamen. Medical treatment including dopaminergic drugs and anticholinesterase inhibitor was ineffective. Case 2: A 57-year-old woman visited us because of MES. Her MES began 4 months before and consisted of her favorite songs. She had no history of hearing impairment. Neurologic examination was normal including hearing. Cognitive function was mildly impaired (MMSE = 22) without any other psychiatric symptoms. Brain MRI was normal. 18F-FPCIT PET showed mild abnormal decrease in the left posterior putamen. Her symptoms were partially responsive to rivastigmine.

Results: Comments: Both patients could describe the songs they heard in detail, which persisted throughout the day. As dopamine transporter scan showed dopamine deficit and clinical parkinsonism was absent, their MES could be an early manifestation of LBD. In the second case, mild cognitive deficit was found and her MES was mitigated with anticholinesterase inhibitor, in which dementia with Lewy bodies can be suspected.

To cite this abstract in AMA style:

S.J. Song, D. Lee, Y.N. Kwon, T.B. Ahn. Musical ear syndrome as a presenting symptom of Lewy body disorder [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/musical-ear-syndrome-as-a-presenting-symptom-of-lewy-body-disorder/. Accessed May 15, 2025.
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