Frédéric Chopin, composer of "The Last Waltz" and poet of the piano, suffered from tuberculosis and regularly hallucinated.

Even for those in the Romantic Revolution, like Liszt, Schumann and Victor Hugo, among others, Chopin was considered frail and hypersensitive and somewhat of a mad genius.   Tuberculosis would claim him at age 39 but a paper published in Medical Humanities says that his hallucinations were not madness, but rather temporal lobe epilepsy.  Hallucinations typically feature in seizure disorders, they say.

The truth is hard to know, of course, and his well-documented bouts of melancholy have been attributed to bipolar disorder or clinical depression and just about every other pop theory but his hallucinatory episodes have been overlooked, suggest the authors.   They draw on the composer's own descriptions of these hallucinatory episodes, and accounts of his life given by friends and pupils, to make their assertion.

For example, during a performance of his "Sonata in B flat minor" in England in 1848 at a private salon, Chopin suddenly stopped playing and left the stage, an event recorded by the Manchester Guardian's music critic.  In a letter written to Solange, the daughter of George Sand (Madame Sand was a pseudonym for a female French author, with whom he lived for a few years - she later left him alleging he was in love with Solange) Chopin described the moment during the performance when he saw creatures emerging from the piano, which forced him to leave the room to recover himself.

In her memoirs, Madame George Sand recalled a trip she and the composer took to Spain in 1838 and described the monastery where they stayed as being "full of terrors and ghosts for him," and various incidents in which Chopin appeared pale, or with wild eyes, and his hair on end. She also recounts the vivid descriptions he gave her of the visions he had had.

There are other accounts, both by Sand and by one of Chopin's pupils Madame Streicher, of similar incidents, and the composer's own description of a "cohort of phantoms" in 1844.  Hallucinations are a hallmark of several psychiatric disorders, such as schizophrenia and dissociative states, say the authors, but usually take the form of voices.

Migraine can also produce hallucinations, but these can last up to half an hour, while Chopin's were often brief; and migraine auras without headache mostly mainly occur in patients over the age of 50, say the authors. Charles Bonnet syndrome is also discounted as Chopin had no eye disorders.

Chopin did take laudanum to quell his various physical symptoms, but the type of visual hallucinations associated with this do not correspond to Chopin's and the composer also began experiencing them before taking this medication, say the authors.

Rather, they think that temporal lobe epilepsy is a more likely explanation as it can produce complex visual hallucinations, which are usually brief, fragmentary, and stereotyped, just like those Chopin said he experienced.

The authors acknowledge that without the aid of modern day tests, it is difficult to make a definitive diagnosis, but comment: "A condition such as that described in this article could easily have been overlooked by Chopin's doctors," adding that there was limited understanding of epilepsy at that time.

"We doubt that another diagnosis added to the already numerous list will help us understand the artistic world of Frédéric Chopin. But we do believe that knowing he had this condition could help to separate romanticised legend from reality and shed new light in order to better understand the man and his life."