Musicophilia: Tales of Music and the Brain Read Online Free PDF Page B

trouble in a noisy, music-permeated environment, so much so that he must wear earplugs most of the time.
    His seizures start with or are preceded by a special state of intense, involuntary, almost forced attention or listening. In this already altered state, the music seems to grow more intense, to swell, to take possession of him, and at this point he cannot stop the process, cannot turn off the music or walk away from it. Beyond this point he retains no consciousness or memory, though various epileptic automatisms, like gasping and lip-smacking, ensue.
    For G.G., music does not just provoke a seizure; it seems to constitute an essential part of the seizure, spreading (one imagines) from its initial perceptual locus to other temporal lobe systems, and occasionally to the motor cortex, as when he has generalized seizures. It is as if, at such times, the provocative music is itself transformed, becoming first an overwhelming psychic experience and then a seizure.

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    A NOTHER PATIENT , Silvia N., came to see me towards the end of 2005. Mrs. N. had developed a seizure disorder in her early thirties. Some of her seizures were of grand mal type, with convulsions and a total loss of consciousness. Others were of a more complex type in which there would be some doubling of consciousness. Sometimes her seizures seemed to be spontaneous or a reaction to stress, but most often they occurred in response to music. One day she was found unconscious on the floor, having had a convulsion. Her last memory before this was of listening to a CD of her favorite Neapolitan songs. No significance was ascribed to this at first, but when she had a similar seizure soon afterwards, also during the playing of Neapolitan songs, she started to wonder whether there could be a connection. She tested herself, cautiously, and found that listening to such songs, either live or on a recording, would now infallibly arouse a “peculiar” feeling, followed quickly by a seizure. No other music, though, had this effect.
    She had loved the Neapolitan songs, which reminded her of her childhood. (“The old songs,” she said, “they were always in the family; they always put them on.”) She found them “very romantic, emotional…they had a meaning.” But now that they triggered her seizures, she began to dread them. She became particularly apprehensive about weddings, coming as she did from a large Sicilian family, because such songs were always played at celebrations and family gatherings. “If the band started playing,” Mrs. N. said, “I would run out…. I had half a minute or less to get away.”
    Though she sometimes had grand mal seizures in response to the songs, Mrs. N. more often experienced just a strange alteration of time and consciousness in which she would have a feeling of reminiscence— specifically, the feeling of being a teenager, or the reliving of scenes (some seemingly memories, others clearly fantasies) in which she was a teenager. She compared these to dreams and said she would “wake” from them as from a dream, but a dream in which she retained some consciousness, though little control. She was able, for instance, to hear what people around her were saying, but unable to respond— that doubling of consciousness which Hughlings Jackson called “mental diplopia.” While most of her complex seizures referred to the past, she told me, on one occasion, “it was the future I saw…. I was up there, going to heaven…. My grandmother opened up the gates of heaven. ‘It’s not time,’ she said— and then I came to.”
    Though Mrs. N. could avoid Neapolitan music most of the time, she also began to have seizures without music, and these grew more and more severe, finally becoming intractable. Medications were useless, and she sometimes had many seizures in a single day, so that daily life became virtually impossible. MRIs had shown both anatomical and electrical abnormalities in her left temporal lobe (probably from a head