A 6-month-old infant with seizures triggered by loud music, especially specific songs of the Beatles, is reported from Chang Gung Children’s Hospital at Linkou, Taoyuan, Taiwan. He was born by cesarean section because of fetal distress and the Apgars were 5 and 8. Partial seizures, consisting of hand raising or mouth twitching, began at age 2 months and were initially controlled by carbamazepine and vigabatrin, started at 6 months. The interictal EEG was normal, but continuous EEG monitoring revealed ictal spikes throughout the left temporal area. MRI was normal. Finally, the seizures became generalized without the musical trigger and were resistant to medication. After 1 year, neurologic examination showed a progressive developmental delay. [1]
COMMENT. The term, musicogenic epilepsy was first coined by Critchley M (1936). Seizures are partial complex or generalized tonic-clonic and they originate in the temporal lobe. Musical specificity varies, classical, religious, military, or jazz; emotional content can be cheerful or sad; and some compositions are more epileptogenic (eg. Wagner, Beethoven). This is the first report of Beatles music as a trigger of seizures. Patients are usually adults, and the report of an affected infant is rare. As in this infant, both music-induced and spontaneous seizures generally occur in the same patient, and loud music is more provocative than soft sounds. The musicality of the patient and the style of music may both play a role in precipitating seizures. In rare cases, music has aborted seizures (in Lennox WG, Epilepsy and Related Disorders, Boston, Little Brown, 1960;p365).