Background Visual hallucinations of Charles Bonnet syndrome (CBS) secondary to visual deprivation occur in 11–15% of elderly patients with acquired visual impairment. It is increasingly recognised that there is an auditory form of CBS consisting of musical hallucinations in elderly patients with acquired hearing loss. Here we present two cases of auditory CBS.

Case 1: An 82 year old man with age related macular degeneration and deafness presented with a 2 year history of transient visual hallucinations which met proposed diagnostic criteria for CBS and a 1 year history of auditory musical hallucinations with retained insight.

Case 2: An 85 year old lady was referred by psychiatrists querying a diagnosis of temporal lobe epilepsy. She described a 10 year history of depression, severe hearing loss, tinnitus and auditory hallucinations. The hallucinations took the form of a limited repertoire of songs, they were more likely to occur when the patient was alone and they affected sleep. The patient retained insight into the hallucinations and had learnt to control them using distraction.

Conclusion Neurologists should be aware of the entity of auditory CBS in the form of musical hallucinations in elderly patients with significant hearing loss.