A man tormented by phantom nursery rhymes while experiencing musical hallucinations has provided a rare insight into the phenomenon, with MRI suggesting it was due to his mild hearing loss.

Neuroimaging experts say their case serves as a reminder to investigate patients who report hearing music with no known source for hearing loss rather than assume they have delusions or psychosis.

In their report, the researchers noted that recent studies had supported a link between musical hallucinations — also known as musical ear syndrome — and psychiatric conditions or focal brain lesions, while others had suggested a pathological response such as hearing loss.

However, the exact mechanism responsible for the condition has remained poorly understood, said Professor Faten Mane Aldhafeeri from the University of Hafr Al Batin in Saudi Arabia.