Middle ear myoclonus forum

Hoping for some advice here. Last August I felt what can only be described as a trembling in my left ear. As time as gone on this trembling because what can best be described as a spasm that I can feel and hear. Its like a continuous process of tension and relax within my ear canal with a bass like sound, similar to a car going past you with the bass turned up. I've had 3 occasions when its been appalling, like having a helicopter inside my head.

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Mainly it is a rumbling sound with a physical feeling, with a dull ache in my eardrum and a weird, slightly numb feeling in my left cheek. Its so strange because if I shake my head it stops, if I plug my ear canal tightly with a finger it stops and then will slowly start to come back after maybe seconds.

And to make it even more bizarre it can go away for a week, or a few days and it will be like I have no problem at all. So from a bit of research and a bit of gut instinct I think I have middle ear myoclonus, which is a treatable condition as I understand it. Has anybody out there suffered from this? I'm willing to seek out any avenues to get this sorted, private doctors, etc. Yes I've had this for about a year I had a half hour phone appointment with one if the consultants at the Tinnitus clinic in London.

He said it would probably diminish and it has. I think I've realised that it's my anxiety about it that's the problem rather than the thing itself, although it's not pleasant. I had a similar experience with the NHS Good luck! Thanks for your insight Peeweecat15! The ray of hope I have is that it randomly turns off for a week, so I know this is non-permanent but at the same time I think I may need some help to help make it disappear full stop.

Glad yours is improving. Could you let me know who you see and whether it helps?This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register. By continuing to use this site, you are consenting to our use of cookies.

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Botox to treat middle ear myoclonus (MEM) syndrome

Tinnitus and middle-ear myoclonus in relation to IEMs. Home Forums Misc. JavaScript is disabled. For a better experience, please enable JavaScript in your browser before proceeding. Thread starter joel96 Start date Mar 11, Post 1 of 3. Joined Dec 9, Messages 28 Reaction score Joined Dec 9, Posts 28 Likes Tinnitus and middle-ear myoclonus in relation to IEMs I have moderate tinnitus in both ears, a t emporomandibular joint disorder on the left side, and middle-ear myoclonus in the left ear; I have myoclonus in multiple muscle groups in the rest of the body long extensor tendon of the right index finger, multiple toes, leg muscles, abs, left orbicularis oculi, etc.

The middle-ear myoclonus is noticeable when wearing most earplugs, or when any weight or pressure is on the left side of the head, and sometimes when no pressure or sound is present; the myoclonus increases in severity with proportion to audio volume. I have a set of JVC-FXs the left monitor is defective; it has a buzz, which increases the severity of the myoclonus temporarily--I either nearly mute the left channel or increase the volume higher than the perceived volume of the myoclonus.

I'm going to try out each one of the replacement fittings to see if the myoclonus decreases. I might stop using IEMs if the myoclonus doesn't improve with changes in diet and vitamin supplements.

I'd like to know if anyone here has had success in reducing subjective myoclonus with a certain type of fitting. I don't know if I should bother looking for a new set of IEMs since the myoclonus is probably permanent.

Understanding How Middle Ear Myoclonus Causes Tinnitus

I realize the following idea is based on minimal information, but it's my personal start. I've thought about mapping the frequencies of the tinnitus in each ear using Audacity to match the frequencies one at a time; some of the frequencies are in distinct ranges; others modulate.

The frequencies of the tinnitus are mostly highs, but the frequencies cover the entire range of hearing from bass to highs. I've thought that it might be possible to invert the frequencies and generate counter-frequencies similar to noise cancelling devices; it would produce even more distortion and noise exposure; if working as intended, the effect would be perceived silence, although to outside observers it would be perceptible noise.

Another possible application instead of cancellation would be to pass audio through a filter in Audacity that would remove the same frequencies from an audio track. Tinnitus is neurologically generated subjective substitution noise for partial deafness at specific frequencies; reduction of the volume of those frequencies may decrease the perceived volume of the tinnitus frequencies. The mechanisms of tinnitus, myoclonus, and temporomandibular joint disorders are not well-understood.

Myoclonus can be treated every six to nine months with Botox injections. Otherwise all there is for subjects is habituation and anecdotal rumors.Middle Ear Myoclonus MEM is a rare form of objective tinnitus that can actually be heard by another person. Myoclonus refers to the spasmodic jerky contraction of a muscle or group of muscles.

Hiccups are a form of myoclonus. In the middle ear, myoclonus can occur in the very small muscles behind the eardrum and in front of the cochlea.

There are two such muscles in the middle ear. The tensor tympani muscle attaches to the malleus bone in back of the eardrum. The stapedius muscle attaches to the stapes bone, that conducts sound to the cochlea. Both of these muscles are protective. They act to dampen sound levels coming into the ear and to reduce the sound of chewing and our own voice.

In the illustration below, the tensor tympani is the long dark muscle connected to the malleus bone inside the eardrum. The stapedius is the short red muscle attached to the stapes bone, the horseshoe shaped object. When the tensor tympani muscle is in spasm, it creates a thumping sound like a tympani drum.

middle ear myoclonus forum

It can also be heard as a clicking sound. The thumping or clicking can produce a frequency as high as times per minute. A doctor can actually see the eardrum vibrating and can hear the sound from cm away.

When the stapedius muscle is in spasm is usually heard as a buzzing, rumbling or crackling sound. It cannot be observed affecting the eardrum but can sometimes be heard outside the ear. MEM is quite rare, occurring in only about 6 in 10, people. But it can be maddening to have the thumping, clicking or buzzing sounds that will not stop. Causes of MEM include being subject to loud sounds such as artillery fire or nearby firecracker explosion.

Stress can also bring it on.

middle ear myoclonus forum

It can be caused by spasm in the facial nerve or the palate. When spasms start, they can often include both ears.

middle ear myoclonus forum

Stress can play a major role, increasing the discomfort of the spasms. Typical treatments include coping strategies and counseling, relaxation and anxiety reduction. Hypnosis and sedatives are sometimes used. Acupuncture and biofeedback can be helpful. Botox injections in the wall of the Eustachian tube will paralyze the muscles and stop the spasms. But Botox is very expensive and wears off in 3 months.

When benzodiazepine anti-anxiety medications are used, they generally begin at a low dosage and are slowly increased until the patient improves or side effects become harmful. This tinnitus is intermittent and has a staccato quality like a typewriter in the background or Morse code.

This type of tinnitus is usually associated with irritability of the 8 th cranial nerve, the auditory nerve. It is usually responsive to the drug carbamazepine.

This medication is commonly used to treat seizures or nerve pain. When other methods fail to reduce MEM, surgery can be employed. Care must be taken because the facial nerve can be damaged during the surgery. Case reports have shown that surgery is very effective, immediately and permanently stopping the spasms, 2.

A very simple, non-invasive treatment has been found that helps some people with irregular MEM.To diagnose myoclonus, your doctor will review your medical history and symptoms and conduct a physical examination. To determine the cause of myoclonus and rule out other potential causes of your condition, your doctor may recommend several tests, including:. This procedure records the electrical activity of your brain and may help determine where in your brain the myoclonus originates. In this procedure, doctors attach small electrodes to your scalp.

You may be asked to breathe deeply and steadily and look at bright lights or listen to sounds, as these actions may uncover abnormal electrical activity. In this procedure, doctors put EMG surface electrodes on multiple muscles, especially on those muscles that are involved in the jerking.

An instrument records the electrical activity from your muscle at rest and as you contract the muscle, such as by bending your arm. These signals help to determine the pattern and origin of the myoclonus. An MRI scan may be used to check for structural problems or tumors inside your brain or spinal cord, which may cause your myoclonus symptoms.

An MRI scan uses a magnetic field and radio waves to produce detailed images of your brain, spinal cord and other areas of your body. Your doctor may suggest genetic testing to help identify possible causes of myoclonus. He or she may also test your blood or urine to check for:. Our caring team of Mayo Clinic experts can help you with your myoclonus-related health concerns Start Here.

Treatment of myoclonus is most effective when a reversible underlying cause can be found that can be treated — such as another condition, a medication or a toxin. Most of the time, however, the underlying cause can't be cured or eliminated, so treatment is aimed at easing myoclonus symptoms, especially when they're disabling. There are no drugs specifically designed to treat myoclonus, but doctors have borrowed from other disease treatment arsenals to relieve myoclonic symptoms.

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More than one drug may be needed to control your symptoms. Drugs used to control epileptic seizures have also proved helpful in reducing myoclonus symptoms. The most common anticonvulsants used for myoclonus are levetiracetam Keppra, Roweepra, Spritamvalproic acid Depakene and primidone Mysoline. Piracetam is another anticonvulsant that's been found to be effective, but it's not available in the United States. Valproic acid may cause side effects such as nausea. Levetiracetam may cause side effects such as fatigue and dizziness.

Side effects from primidone may include sedation and nausea. OnabotulinumtoxinA Botox injections may be helpful in treating various forms of myoclonus, particularly if only a single area is affected. Botulinum toxins block the release of a chemical messenger that triggers muscle contractions. If your myoclonus symptoms are caused by a tumor or lesion in your brain or spinal cord, surgery may be an option.Using Botox to treat middle ear myoclonus MEM syndrome a form of tinnitus is an attractive option.

Tinnitus is a symptom and described as the perception of sound without an appropriate external source. Myoclonus is the rhythmic contraction of a muscle and in the case of MEM syndrome of either, or in rare cases both, of the middle ear muscles.

It may lead to anxiety and depression. Botox protein, also called Botulinum toxin blocks a chemical namely acetylcholine in the nerve- muscle junction. The result is that the nerve impulse cannot elicit a muscle response. Used in many areas of medicine where muscle contraction is unwanted or where muscle response is uncontrolled or spastic it is now a well-established world-wide treatment.

Unfortunately, the effect of Botox is usually transient, being effective for only months. The patient responded well and was symptom free for 4 months.

Objective Tinnitus From Middle Ear Myoclonus

The middle ear muscles. The middle ear contains two muscles namely the stapedius muscle and the tensor tympani muscle. They attach to different ear bones ossicles and are innervated by separate cranial nerves. The function of the stapedius muscle is to stiffen the ossicular chain at the level of the stapes and is likely to attenuate external sound in order to protect the cochlea. The tensor tympani muscle attaches to the malleus a by contracting stiffens the ossicular chain at the level of the malleus and tympanic membrane.

This action leads to the attenuation of internal body sound generated when swallowing, chewing and talking. Another function of these muscles is to produce movements at the ossicular joints for the joints to stay healthy and work effectively in protecting the tympanic membrane against ambient pressure changes.

The sound may also be described as bubbling, thumping, whooshing, gushing, ticking, crackling, throbbing or tapping.

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In rare cases the noise may be heard by another person. This is then referred to as objective tinnitus. It is difficult to distinguish between myoclonus of the stapedius muscle and myoclonus of the tensor tympani tensor tympani or TT syndrome based on the reported characteristics of the sound.

The examination is usually normal but, in some cases, a rhythmic movement of the tympanic membrane may be seen, sometimes initiated by eye blinking. Audiometry is not used for diagnosis but in some cases long-term audiometry may show a characteristic appearance. Conditions that may mimic MEM syndrome include palatal myoclonus and patulous eustachian tube.

In palatal myoclonus the contraction of the soft palate can be visualised and in a patulous eustachian tube patients can hear their own voice autophonia and rhythmic movement of the tympanic membrane in tandem with breathing can be visualised. In most cases the cause is unknown. Anxiety plays a major role and is believed to lower the threshold for the occurrence of the muscle contractions. Other conditions that may be responsible for objective tinnitus and need to be excluded include abnormal blood vessels, atherosclerosis, vascular tumours such as paraganglioma and multiple sclerosis.

Using Botox to treat middle ear myoclonus MEM syndrome is an attractive management option.Stapedial tendon myoclonus is a rare but treatable disease. Patients with stapedial tendon myoclonus experience a fluttering sound in their ear. This may occur in one or both ears. Patients usually describe the sensation as a butterfly flapping its wings or the sound of a very rapid heart beat. If the fluttering becomes very fast, the clicks can blend and sound like a machine-like humming sound.

middle ear myoclonus forum

It is important to distinguish the clicking and crackling that can be experienced in the more typical Eustachian tube dysfunction from the fluttering that occurs in myoclonus. Stapedial tendon myoclonus may occur without a known cause. In some patients, it may begin after a stressful period. Certain electrolyte disturbances can cause myoclonus, as can some medications. Importantly, myoclonus can be an early sign of a larger, neurological disease.

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For these reasons it is important for your doctor and otologist to fully evaluate you and rule out more serious causes. The main tests include a hearing test and a tympanogram, which measures the movement of your ear drum.

Visualization of the ear canal and ear drum with an otoscope or microscope is also important to see if any movement can be detected. Your otologist may also need a CT scan if preparing for of the myoclonus. Some forms of myoclonus can be treated by addressing the actual disease that may be causing it, such as stress, an electrolyte imbalance, or neurological issue.

If surgery is necessary, your otologist may offer you a procedure wherein the tendon of the muscle that is spasming is ligated. The surgery for myoclonus is minimally invasive, and has a very high success rate. Myoclonus of the stapedius and tensor tympani tendon. What causes stapedial tendon myoclonus? How is stapedial and tensor tympani myoclonus diagnosed? Contact OHNI. Request or schedule your appointment date online by filling out the appointment scheduling request form below and you will be contacted within 48 hours to confirm your date.

Year Yes, I'm new patient No, I'm a returning patient. Please choose your preferred consultation: phone, in-office, or video consultation. Accepted file types: jpg, gif, png, bmp, pdf, jpeg. First Last.It may get better but I don't think rushing in for surgery is such a great idea been on the ear clicking threads long ago. Didn't have that problem at all before that.

Bone can vibrations in general and with hyperacusis expecially my bones were vibrating and conducting sounds making things sound louder even inside my head. But otherwise The TRT exercise may be helpful for you. So trying it sounds good to me. Go for it! Note: Your browser does not have JavaScript enabled. Many features may not work properly without it. Please enable JavaScript in your browser settings. I had the surgery a month ago. It did not work for me. I had what felt like spasms behind my ear drum.

They just come on randomly. The surgery wasn't to bad. My ears rang bad for about a month, but are getting better. The spasms seemed to stop at first but have come back. I am going to have Botox injected into the Eustachian tube to see if that works. Hang in there I know how difficult this is. To splpd: How do the spasms feel like? Can you hear any clicking sounds?

Sorry to hear that your spasms are not gone yet. Maybe the effects of your surgery will start to take effect after some months? I just wonder why you botox eustachian tubes; in what way will it help? Oh, and one last question and then ill stop bothering youxDwhat tendons in your ear did you remove? If I understood it right, there are two tendons stapedial and tympani.

To John: What excactly do you mean by spasms and what the heck is that brain theraphy thingy? If I got thumping and some spasms here and there, I would have not considered going for surgery!

Its just that mine is related to talking, and its really annoying especially since its in both my ears. Its hard to tell what it is.