Recurrent refrains in a patient with multiple sclerosis: Earworms or musical hallucinations?

Musical hallucinations are recognized in certain neurological and psychiatric conditions and can be caused by focal brain disease (Evers and Ellger, 2004). However, the occurrence of primary musical hallucinations in multiple sclerosis (MS) has not been reported previously. We report a case of a 54 year old woman with progressive, relapsing MS who has continuous, unremitting, complex auditory phenomenon for an extended period of time. We believe that MS lesions rather than medications are the cause for this disturbing symptom and we present a brief review of the literature regarding the current views on the neural substrates of musical perception and cognition.