Music, a form of art; epilepsy, a fearful disease. Two totally different subjects. What could do they have to do with one another? Here we will discuss the relationship between these two seemingly unrelated topics.

Music is for pleasure. People write, perform or listen to music to express their feelings. Listening to a piece of music can bring tears or joy. Even singing a song without understanding the words can comfort or encourage people.  But did you know lovely music sometimes can cause a seizure? Epilepsy caused by listening to music, playing music, or even thinking of music is called musicogenic epilepsy. Like music, musicogenic epilepsy is not new.  According to archaeologist, the earliest music instruments besides human voice were percussion instrument made of stones, sticks, rocks about 165000 years ago. The first musicogenic epilepsy was described by a French scholar, Jose J Scalinger in the 16th century. Nikonov, a Russian music critic of the 19th century wrote his seizure experience in a title of “fear of music.” His first seizure occurred while he was attending an opera.  While watching Meyerbeer’s “The prophet”, Nikonov reportedly became tremulous, sweated profusely and his left eye started to twitch. From that time, music, the enjoyable art to many people, became a torture to this music critic career. In the end, even slight music stimuli could lead him to have headache, convulsion, or loss of consciousness, so he had to quit his profession. Nikonov’s experience was also documented by neurologists and psychologists and published in medical journal. According to statistics, there are one in a million people who suffer from musicogenic epilepsy. With the modern technology, such as radio, TV, iPhone, iPod, more and more people are exposed to music more often. Nowadays, living without music has almost become a mission impossible.  Music is everywhere, in every culture. Thus, it is likely that more people will be diagnosed with musicogenic epilepsy.  Patients with musicogenic epilepsy usually have their seizure within minutes of hearing the music. Often seizures predictably occur in response to a specific type of music or even a specific song. Sometimes the seizure can be aborted. Most musicogenic epilepsies manifest by complex partial seizures arising from the right temporal lobe. Like other partial (focal) seizures, they can evolve into (secondary) generalized convulsions. And like other partial seizures, they can be treated with surgery if drugs fail to control them.

Singing can be a manifestation of epilepsy. Have you heard singing seizure? Singing seizure is a type of verbal automatism often observed during complex partial seizures, but is considered rare. Automatisms are repetitive and stereotyped behaviors that occur during partial seizures, and of which the patient is usually unaware.  

Finally, is it possible music even be a treatment for epilepsy? Music therapy? In 1991, a French researcher, Alfred Tomatis first introduced the term “Mozart Effect” in his book “why Mozart.” He believed that listening to Mozart helped promote healing. In 1993, a paper published in Nature, a prestigious scientific journal, concluded that listening to Mozart’s sonata can temporary enhance spatial-temporal reasoning. Subsequent researches found that not only Mozart’s music (sonata K448, piano concerto No. 23 K488, piano sonata in E Flat Major K282), but music from several other composers including Haydn and Liszt, as well as a song called “standing in motion” from Yanni (a Greek composer and singer) decreased epileptiform activities in patients with epilepsy. The effect may even be “dose related” like medications, that is the longer the music exposure, the stronger the effect. Maybe Mozart K448 should be given as add on therapy to medications. An interesting question is whether it would also help patients in a coma or status epilepticus.

So perhaps like foods, we should choose our music wisely. Happy listening!

Lingling Rong, MD, and Selim R. Benbadis, MD
Comprehenive Epilepsy Program
University of South Florida

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