The effect of listening to Mozart’s Sonata for Two Pianos (K448) on the frequency of interictal epileptiform discharges (IEDs) in the EEGs of four children, ages 5 – 9 years, with benign childhood epilepsy with centrotemporal spikes (BCECTS) was studied in a prospective, randomized, crossover, placebo-controlled trial at the Medical University of South Carolina, Charleston, SC. IED frequency per minute was averaged over each of 3 periods per hour in 4-hour continuous awake EEG recordings: 1) silence/baseline, 15 min; 2) K448 (first and second movements) or control (placebo) music (Beethoven’s Fur Elise), 18 min; 3) washout period, 27 min. In 2 subjects who demonstrated sufficient waking IEDs for statistical analysis, consisting of 3 epochs of K448-related effects, significant decreases in mean IEDs per minute (33.7, 50.6, and 33.9%) were demonstrated when comparing baseline with exposure to K448, but not with control music. The mechanism of the Mozart effect on IEDs is unknown but an alteration in spike generation is possibly involved. 
COMMENT. The history of the so-called Mozart Effect is reviewed by Turner who cites several references in the above article. In previous studies beginning in the early 1990s, statistically significant improvement in spatial reasoning skills on Stanford-Binet intelligence scales was demonstrated in college students listening to Mozart’s K448 piano sonata in D major (Rauscher et al, 1993). In the late-1990s, Hughes, Shaw and colleagues demonstated antiseizure and antiepileptogenic benefits of listening to K448, an effect related to the organization and repeated melodic line of Mozart’s music. The complex cortical processing of music may explain the various neuroanatomic and neurophysiologic effects demonstrated in studies of the Mozart Effect. The significance of interictal epileptiform discharges and their control in the treatment of epilepsy is controversial. Nonetheless, this pilot, controlled study of the Mozart Effect, if confirmed in larger studies, could lead to new treatment interventions in epilepsy.