hbep

Hi Jamie,

I've actually posted this once before, but wanted to post this description of myoclonus once again, (I have put it at the bottom of this message) as it sounds so like what you're going through. If you read it carefully you 'll notice that the people who've written this article mention that people who have it often have tempero mandibular joint problems - they say 'Frequently a history of muscle spasm with occipital headaches or temporomandibular joint pain can be obtained.' Also, they don't mention any other underlying reason for it, so I don't think the ENT's you've seen have missed anything. They also say that it does eventually resolve itself. Believe me, I understand what you're going through - have experienced some of these things, and yes, they're depressing, but they are also made much, much worse by stressing over them. Also, although I truly believe you will be rid of your symptoms, but you will require patience. Splint therapy rarely works in 5 minutes - your muscles are strained, and strained muscles need time to rest, that's what your splint is doing. If you pulled an arm muscle very, very badly and it was put in a sling, would you expect it to be better in 3 days?No. Would it bother you? Not as much as this because you'd be able to see why it had happened, and trust it would get better. Because this is your ears, it feels much scarier, and it's harder to grasp that your muscles are strained inside an ear.

I think you are made most upset by the idea that this isn't caused by tmj, or that there is a reason for your problems out there that are not tmj induced and which, if discovered, would throw up a cure. As, what you describe, sounds so like a muscular spasm problem in your ears - YOU WILL GET BETTER - but it really doesn't sound like there is a quick fix, or a drug that would instantly cure this, even if it turned out not to be tmj related. When I had a similiar problem to you - a violent vibration in the ears that reacted to sound - I did get some relief from a very, very low dose of valium, (valium acts as a muscle relaxant) which I only took when it was very bad. Valium is highly addictive, you want to use it sparingly. I also learned that the more I stressed (and boy did it send me nuts for a while) the worse it got - a spasming muscle reacts very badly to tension in the body. I learned that I could control the symptom to a degree by making a massive effort of will to relax, breath deeply, not let the scarey symptom make me tense up. Once I no longer allowed myself to freak out, the symptom started to get much more manageable and to ease up in intensity. I get it much less now and when I do it's much less severe. I have also been using a splint for 4 months - everyone is different, you could see results sooner, but it was at about 4 months that I started to see a real difference.

You will get better Jamie, you have to trust in that, but it will require you to be patient and also not to stress too much over it.

Here's the article I was talking about, it really is worth reading carefully.

TINNITUS
Current Evaluation and Management
Written By

D. Scott Fortune MD
David S. Haynes MD
Jay W. Hall III PhD


Neurologic Disorders
Neurologic disorders that cause objective tinnitus include palatomyoclonus and idiopathic stapedial muscle spasm. Palatomyoclonus is characterized by an irregular clicking sound within the ear. The myoclonus is rapid with a rate between 40 and 200 beats/min and occurs intermittently. The sound is generated by the mucous membranes of the eustachian tube snapping together as the palatal musculature undergoes myoclonic contractions. Patients may also complain of aural fullness, hearing loss, or sound distortion. Symptoms are worsened by stress. Frequently a history of muscle spasm with occipital headaches or temporomandibular joint pain can be obtained. The diagnosis can be made on physical examination by listening for the noise with a Toynbee tube or viewing myoclonic jerks in the palate. Tympanometry can occasionally record movement synchronous with the palatal contractions. Rarely, electromyography of the palate is indicated to confirm the clinical diagnosis. Treatment of palatomyoclonus is medical. Antispasmodic agents and muscle relaxants, such as clonazepam or diazepam, are the mainstay of treatment. Neurologic consultation is useful for long-term management of these patients.

Idiopathic stapedial muscle spasm creates a rough, crackling, rumbling noise in the ear. External sounds, such as music tones, water faucets, and voices, are known to accentuate the spasms. Physical examination reveals a normal tympanic membrane with rhythmic contractions synchronous with the noise. History and physical examination are sufficient for diagnosis. The disease is usually self-limited and remits with time; reassurance is often sufficient.

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hbep