Illustration by Maria Hergueta
A musicogenic seizure is reflex epilepsy triggered by certain types of music or even specific frequencies of pitch for which the person’s brain has a low threshold or tolerance. These sounds trigger focal epileptiform EEG discharges in cerebral areas specific to the triggering stimulus. This usually results in focal seizures but may also induce others, such as tonic-clonic seizures.
Musicogenic seizures usually involve a degree of cognitive or emotional appreciation of the stimulus. In some cases, merely thinking of the atmosphere and the emotions associated with a certain stimulus is enough to induce a seizure. They may also occur during sleep.
Carbamazepine and phenytoin may be prescribed to control this condition. Behavioural conditioning offers other possibilities and has yielded positive results. In behavioural treatment, the patient is exposed repeatedly to a similar piece of music or even to the same piece altered sufficiently to not provoke a seizure. Eventually, the original stimulus may be heard with no ill effect.
Behavioural treatment may be time-consuming, and may need to be reinforced later to maintain desensitization. In spite of this, behavioural conditioning may prove effective in the treatment of people who do not want to avoid the triggering stimulus or take medication.