Auditory hallucinosis consists of abnormal acoustic perceptions that occur in the absence of a corresponding acoustic stimulus while the patient is aware of their non-real nature.1

Musical hallucinosis represents a particular type of acoustic hallucinosis, in which the acoustic perception is formed by music, sounds, or songs. It is frequent in psychiatric diseases and is sometimes reported in sensory neural deafness, but rarely after stroke.1 2 We describe a case of musical hallucinosis in a professional musician with a left subcortical haemorrhagic lesion, presumably caused by a cavernous angioma.

A 35 year old, right handed man was referred to our inpatient department in July 1999 7 days after the onset of a slight clumsiness of his right hand followed by complex acoustic perceptions. The patient had attended a symphonic concert where an orchestral transcription of Wagner's “Siegfried” was played: the patient is a connoisseur of music and a composer. When he returned home, about 1 hour later, his musical hallucinosis started. Auditory perceptions were described by the patient as a symphonic piece of music performed by an orchestra with numerous kettledrums and percussion instruments. It was a rather familiar music, unknown to him, but similar to what he had heard during the concert. The theme was played in a minor tonality with frequent use of drums and other percussion instruments interspersed with string instruments. A chorus played by string instruments accompanied the theme. …