BRAIN and NERVE－神経研究の進歩70巻11号

2018年11月発行

増大特集 脳科学で解き明かす精神神経症候

音楽性幻聴

著者： 二村明徳¹ 河村満¹² 小野賢二郎¹

所属機関： ¹昭和大学医学部内科学講座脳神経内科学部門 ²奥沢病院

ページ範囲：P.1147 - P.1156

文献概要

音楽性幻聴（musical hallucination）は音がしていないにもかかわらず，音楽が聞こえる，特異な症候である。音楽性幻聴は高齢者に多く，背景には，難聴や精神疾患，局所性脳病変・びまん性脳萎縮，てんかん，薬剤・中毒などが報告されている。中でも難聴は頻度の高い合併症であることから，聴覚性シャルル・ボネ症候群とも呼ばれ，感覚遮断における音楽性ネットワークの過活動と考えられている。いまだ確立された治療法はないが，抗てんかん薬，認知症改善薬，抗精神病薬などで改善の報告がある。近年，視床皮質リズム異常や顕著性ネットワークが音楽性幻聴に関わることが明らかになってきた。また，近年，認知症患者の行動理解や精神ケアへ関心が高まっている。認知機能低下によるシャルル・ボネ症候群が生み出す幻覚は，患者の豊かな精神世界の理解につながるかもしれない。

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