We just came from a series of training Community Health workers down at Kwale and Mombasa County as we gear up for the “Angaza Kifafa” Campaign due next Month. In the process I pick a conversation with one of the participants and before I could say anything she reaches out to me and says…”Daktari…I think I just recently found a trigger for me, but I’m not sure. I was listening to the radio in the car while my brother was driving and Brittany Spears “Three” came on. It has a really computerized sound and lots of bells and beeps that are repeated and staggered. I had gotten a really bad headache almost instantly and then went into convulsions. I am honestly not sure if this was because of the song or because of something else”.
Musicogenic epilepsy is a rare disorder; seizures are triggered by certain types of music, frequencies of sound or pitches that a person is unable to tolerate either cognitively or emotionally. Not only can seizures be triggered by the sounds themselves, but also hearing music that induces certain emotions to the listener. Some patients seem to be able to induce seizures by thinking about certain situations that inspire their triggering emotions. Musicogenic seizures can either occur while either awake or asleep. Diagnosis is determined through an EEG, a physical exam, and the events triggering the seizures. With no prior health concerns in many individuals, these events can begin at any point in life.
Based on findings presented at the 123rd Annual Convention of the American Psychological Association, the brains of people with epilepsy appear to react differently to music than the brains of people without the disorder.
In roughly 80% of epilepsy cases, seizures appear to start in the temporal lobe. Because music is processed in the auditory cortex in the same area of the brain, Charyton and colleagues, of The Ohio State University, were interested in studying the effects of music on the brain of people with epilepsy.
Music plays an important part in epilepsy. A great review by Melissa Maguire titled “Music and its association with epileptic disorders” was published in the volume “Music, Neurology, and Neuroscience: Evolution, the Musical Brain, Medical Conditions, and Therapies” of Progress in Brain Research, earlier this year.
As discussed in that review, the connection between music and epilepsy is very complex and interesting. This is because music actually has a dichotomous effect on epileptic seizures – in some patients, music brings benefit, while in others, music can trigger seizures and lead to musicophobia. And there are also those cases where musical hallucinations arise as part of an epileptic seizure.
Music as a trigger of epileptic seizures
Musical triggers work in various ways. Some patients report seizures only when listening to specific musical genres or to specific musical instruments. But there are cases where the trigger is a specific composer or even a song.
For example, there are patients reporting seizures after listening to The Beatles, Chopin, “The Marseillaise” (France’s national anthem), the X-Files’ theme song, both Whitney Houston and Boyz II Men, Shania Twain’s ballads…
But the stimulus doesn’t necessarily have to be auditory; there are also reported cases where seizures were triggered merely by singing or thinking of music.
Clinical studies using fMRI have provided evidence of an emotional component to musicogenic seizures, suggesting that, at least in some cases, seizures are triggered by the emotional response to music as and not by the auditory stimulus. Seizures stimulated by thinking of music also support this theory since there is recruitment of musical memory and its associated emotions.
But that may not be the case when neutral music induces seizures, such as a specific sound or instrument. Here, the auditory stimulus is most likely responsible.
Music is everywhere. So, naturally, having musicogenic seizures can easily lead to a constant fear of having a seizure and, consequently, to musicophobia. This in turn can lead to social isolation and, ultimately, to depression
Music as a symptom of epileptic seizures
Music can also be part of the clinical features of a seizure. And it can occur in multiple forms.
Musical hallucinations are one of them – in rare cases, hallucinations can occur as part of temporal lobe epilepsy. These can be simple sounds, a more complex melody, or even a specific song. There is another weird and fascinating case report where a 50-year-old man described that, before the onset of his seizure; he had a vivid musical hallucination of his favorite song: Pink Floyd’s “Another Brick in the Wall”.
Musical craving or musicophilia is another rare and fascinating phenomenon. There are reports of musicophilia development following treatment of temporal seizures. These are thought to also be highly associated with an intense emotional experience during musical exposure; the seizures may have led to a change in the emotional response processing in the brain.
There are also reports of compulsive singing, humming, or whistling occasionally arising in association with seizures. These may represent forms of automatism occurring as a release phenomenon or a learned motor pattern.
The emotional components of speech, including melody, pitch, intonation, and gestures, are collectively known as prosidy. These components may also be affected during a seizure, inducing what is known as aprosidy. Likewise, a loss of musical ability (amusia) can also occur.