Post-Surgery Musical Hallucinations of a Patriotic Canadian Song
Bibliographic record
Abstract
A 79-year-old, right-handed, widowed female with bilateral sensorineural hearing loss of a few years' duration, presented to a peripheral hospital with a fall.The fall resulted in a subcapital fracture of the right hip without head injury.She underwent a cannulated screw fixation of the right hip and was discharged to a rehabilitation facility a few days thereafter.She began to experience neck pain and progressive motor weakness of her upper and lower extremities, with sensory deficits in the upper extremities bilaterally.After a few weeks, she could only mobilize with a wheelchair.Bowel and bladder function remained intact.A magnetic resonance image confirmed a 2.4 cm x 1.9 cm dural based mass seen anteriorly at the foramen magnum, causing cervicomedullary junction cord compression.She underwent an uneventful resection of the mass with a C1-C2 laminectomy (Figure).The mass was determined pathologically to be a meningioma.Postoperatively, she reported hearing "The Maple Leaf Forever", a Canadian patriotic song, amongst some Elvis Presley favourites, though clearly had insight that these were hallucinations.In fact, the musical hallucinations began a few days following her hip repair, but she had not brought this to medical attention fearing she would be labeled as 'crazy'.The phenomenon was bilateral.There was no tinnitus.She denied any illusions, delusions, and additional perceptual disturbances.She also had a history of depression, though stable with psychotherapy and an antidepressant.She denied any alcohol or illicit drug use.She had bilateral sensorineural hearing loss and had not worn her hearing aids since the hip surgery fearing they would be misplaced in hospital.Prior to her recent fall, she was independent for all her activities of daily living and independent activities of daily living, except for using a walker to ambulate.She was widowed, lived alone, and had two supportive daughters.She was not experiencing low mood, but had vegetative symptoms of depression including weight loss (nine pounds since her hip surgery), fatigue, and insomnia.While dismayed at her lack of progress with physiotherapy, she remained motivated.She was on dexamethasone as part of neurosurgical management for the meningioma.Her other medications were citalopram, amlodipine, dalteparin, alendronate, vitamin D and calcium.Her affect was flat, but she was alert and attentive.She had sensorineural hearing loss bilaterally.She could sing the song "The Maple Leaf Forever" and return to a different verse when interrupted.Cognitive testing included a Mini Mental State Examination score of 29/30, losing a point for visuospatial construction.Other than 4/5 power in the upper extremities,
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".