Musical hallucinations are a rare subtype of complex auditive hallucinations where we can find a disorder of the processing of complex sounds and the perception is formed by music, instrumental sounds or songs.

A 75-year-old women, accompanied in otorhinolaryngology consultation in the last two years, was oriented to psychiatry consultation for suspected anxious symptomatology. In the second psychiatric observation, she complained of hearing portuguese popular music since the previous month. She could identify the lyrics and sing the songs heard and allocated the sounds out of her head, although having doubts about their reality. There were no other auditory or visual hallucinations. She refused to take psychopharmacs. She had a previous history that included complains of hyperacusis and tinitus, mainly in the left ear. An electrococleography made in the past showed endolymphatic hidropsis at the left and an audiogram identified presbiacusis. Her cerebral MRI showed a dilatation of the ventricular system. She had mild hypertension and hypercholesterolemia and had been medicated with sinvastatine, carvedilol, omeprazole, triflusal and betahistine dihydrochloride.

Musical hallucinations occur mainly in females and in patients over 60 years, although patients whose hallucinations are caused by focal brain lesions are significantly younger. Because most of the patients have a hearing impairment, a similar mechanism to that of Charles-Bonnet syndrome has been proposed.

There is no accepted classification of musical hallucinations - many authors prefer to call them halllucinosis when patients have insight; others think it can represent a mental image. Treatment is not consensual.