Why do I hear music in my head?

Question

Hello doctor,

Before you get bored with my lengthy question, let me say upfront - the end of this story is that I had a stroke. No one can tell me whether what I experienced before that was related.

About five months ago, I started hearing music in my head. I am almost 70 years old, and this has never happened before. It began as just music, not even a particular song, more like I was composing it myself. It played softly in the background, mostly when I took my usual afternoon nap around three or four, but not at night.

Over time, the music grew louder. Then, about a month ago, it changed; it became very loud and overwhelming, and it shifted from random music to specific songs. “The Star-Spangled Banner” played loudly and perfectly in tune. After about a week of that, other songs began to play as well.

Eventually, the music became constant, morning, afternoon, bedtime; it never stopped. It got to the point where it was driving me crazy. I had already looked online about “earworms” and similar conditions, and I even told my wife that I needed to see a doctor because I couldn’t make it stop.

Then I had a stroke.

I woke up one morning, and my whole right side was useless. I couldn’t coordinate any movement, and when I tried to speak, my words came out garbled. Naturally, I went to the doctor. I had two tests: one on my neck and a CT (computed tomography) scan, but they found nothing.

Here is the strange part: the music stopped. Just like that, after months of constant music, it disappeared. No one has been able to tell me if the two are connected.

Please suggest.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and understand your concern.

The musical sounds you experienced could be related to dysfunction in the temporal lobe, possibly due to reduced blood flow in that region. Chronic narrowing of the brain’s blood vessels (known as atherosclerosis) can lead to decreased function in specific areas of the brain, and since each region controls different functions, the symptoms vary accordingly.

When the blood vessel narrowing progresses to complete blockage, it results in a stroke affecting that particular brain region. This loss of function could explain why the music stopped after your stroke. The most likely underlying cause appears to be atherosclerosis.

To confirm this, I recommend undergoing a magnetic resonance imaging (MRI) scan of the brain, which can provide detailed information about the affected area.

I hope this clarifies your concern.

Please let me know if you need further assistance.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I have read your query and can understand your concern.

The fact that you were on blood thinners may explain why the motor deficit disappeared. It seems that the blood thinner has caused the blood clot to dissolve. On the other hand, you should know that the blood thinner does not protect you 100 percent from a stroke or blood clot.

Otherwise, we would live forever while taking blood thinners, and strokes would not exist.

Regarding the brain computed tomography (CT) scan, you should know that within 24 hours of brain ischemia (blood clots), it may not reveal any changes. The same happens in cases of small strokes, which are usually not detected by a simple CT scan, especially if performed within the first 24 hours.

For this reason, I would recommend performing a brain magnetic resonance imaging (MRI), which is a more accurate test for small strokes, even in the early hours. Anyway, you should also know that MRI is not usually used in the emergency room (ER) service because it takes a longer time to perform (half an hour) compared to the short time needed by the CT scan.

Regarding hearing music, this is really a rare case, but I have already had patients like you. So, it is not extremely rare. The temporal lobe is in charge of our memories, especially memories related to hearing (auditory memory).

That is why I thought about it when considering auditory hallucinations followed by a motor deficit (probably related to a temporary low blood perfusion in this area).

I hope this answers your query.

Let me know if I need to assist you further.

Thank you.

Answer 3

Hello,

Welcome back to icliniq.com.

Your symptoms can be related to low blood perfusion to the brain or an eye disorder. For this reason, I would first recommend performing a Doppler ultrasound of the carotid arteries to examine the blood flow in the carotid and vertebral arteries and investigate for possible narrowing or atherosclerotic plaques.

It is also important to closely monitor your blood pressure values during those episodes. Low blood pressure can mimic all these clinical situations. If your Doppler ultrasound shows no significant narrowing and your blood pressure values are normal during these episodes.

I would recommend consulting an ophthalmologist for a physical exam. I remain at your disposal for any further questions whenever you need.

I hope this answers your query.

Let me know if I need to assist you further.

Thank you.

Answer 4

Hello,

Welcome back to icliniq.com.

I have read your query and can understand your concern.

Coming to this point, I would recommend performing a brain MRA (magnetic resonance angiography) to examine the blood flow to the main carotid arteries and intracranial arteries. Another possible test to consider would be a transcranial Doppler ultrasound, which can help examine the blood flow in the main intracranial arteries.

Considering the 70 percent narrowing in your carotid artery, I would recommend discussing with your doctor on the above issues. It is also necessary to take statins, especially if your cholesterol levels are high.

In the meantime, I would recommend continuing to take blood thinners, which can help prevent a possible stroke, and take plenty of water, in order to maintain an adequate blood supply to the brain.

I hope this answers your query.

Let me know if I need to assist you further.

Thank you.