Saturday, February 25, 2006

Get those butterflies back in your stomach, Susan!

Susan writes:

A couple of weeks I started getting something I call "ear flutters." It happens only in the late evening (every night now) except for one afternoon episode. My head/ears feel full, and a sound/sensation starts in my right ear. I can describe it as a rapid irregular beat with a tiny mallet, or a very muffled putt-putt from an old outboard motor.

Onset coincided with increased stress and a slight worsening of tinnitus. I'm guessing either my arteries are involved or a space alien has invaded my eardrum.

This is most likely myoclonus. Myoclonus, by the way, is a two bit medical word meaning "muscle twitch." You have two eensy weensy muscles in your middle ear, the tensor tympani, and the stapedius. Either can develop a twitch. Because of where they are located and what they are attached to, a twitch in either of these muscles produces a fluttering sound, and sometimes also a fluttering sensation.

According to this website, middle ear myoclonus can be a symptom of TMJ, multiple sclerosis, intracranial neoplasm, or cerebrovascular disease. That's news to me. In my experience, middle ear myoclonus tends to be idiopathic (no apparent explanation) and goes away with time and/or conservative treatment (muscle relaxants, for example).

Middle ear myoclonus must be distinguished from vascular tinnitus. Vascular tinnitus is a rhythmic sound which follows the pulse. This is a whole different ballgame, and requires a considerably different diagnostic approach.

Here's an interesting online discussion of middle ear myoclonus. One of the participants insists that cutting the muscle is the only cure. Again, relying upon my experience, surgery is rarely necessary (I have never had to refer anyone for this operation). If I ever met a patient with such persistent, intractable myoclonus, I suppose I would go ahead with the appropriate scans to rule out MS or tumor.

By the way, I agree with what Jambo and JoeM say in their first few posts regarding ENTs: unfortunately, there are a few ENTs who don't know about this condition.

Mind you, I haven't read all of their discussion, so I don't vouch for what they have to say. It will give you the opportunity to hear others' experiences, though.

Needless to say, you should find an ENT familiar with this condition and pursue it with him/her.

D.

25 Comments:

At 4:33 PM, Blogger Susan said...

Thank you, Doug! That makes sense and is reassuring. Although I still think the space alien theory has some merit.

 
At 7:42 PM, Blogger mm said...

Oh for... Clearly Dr. Hoffman is part of the system, Susan. He'd like you to believe you have a little muscle fluttering in your ear - that's the company LINE!

Make a tinfoil hat NOW. And remove any copper piping from your home. And it wouldn't hurt to cover all your windows with duct tape.

That'll take care of your fluttering. But you'll never hear it from the man.

 
At 10:42 PM, Anonymous Doug Hoffman said...

Maureen, are you home right now? Good! Stay there while the men in white suits come to pick you up and take you for your, erm, holiday.

 
At 2:50 PM, Anonymous Anonymous said...

I am a chiropractor, and I ahve encountered many cases of middle ear myoclonus (including my own case, which went on for 3 weeks when I was in college). The problem can also be caused by tight muscles, spasms, and motion dysfunction in the upper neck area (ie, Occiput, C1 and C2)which cause nervous "feedback" and get those middle ear and palate muscles twitching. I have had profound success with a simple chiropractic adjustment of the neck (I'm talking instant releif). The condition also seems to be linked to stress, bad neck posture (such as craning your head over a book for hours and days), caffeine & stimulants, and allergies. So please folks, if you have this problem, don't immediately assume that we have to inject Botox into your palate muscles or load you up on Flexeril. And you are most likely not being controlled by aliens, but if that makes you feel better....Hope this helps.
-Doc Noakes

 
At 2:52 PM, Anonymous Anonymous said...

I am a chiropractor, and I ahve encountered many cases of middle ear myoclonus (including my own case, which went on for 3 weeks when I was in college). The problem can also be caused by tight muscles, spasms, and motion dysfunction in the upper neck area (ie, Occiput, C1 and C2)which cause nervous "feedback" and get those middle ear and palate muscles twitching. I have had profound success with a simple chiropractic adjustment of the neck (I'm talking instant releif). The condition also seems to be linked to stress, bad neck posture (such as craning your head over a book for hours and days), caffeine & stimulants, and allergies. So please folks, if you have this problem, don't immediately assume that we have to inject Botox into your palate muscles or load you up on Flexeril. And you are most likely not being controlled by aliens, but if that makes you feel better....Hope this helps.
-Doc Noakes

 
At 2:54 PM, Anonymous Anonymous said...

Oops-sorry about the double entry. I don't do the blog thing much. I have probably made some terrible blog faux pas.
-Doc Noakes

 
At 2:42 PM, Anonymous Anonymous said...

nice one dougie, i think i have just found out why my ear is constantly 'ratteling'! it has been driving me crazy now for the last few days! Its like chinese water torcher! I too described it as an alien trying to get out of my head, either that or my conscience!

 
At 1:49 PM, Blogger volky said...

I started out with ear pressure
went to ear noise. Doc's say no infection. My ent thinks i muscle related TMJ stress. I got the prescription and I'm keeping fingers crossed.

 
At 4:06 PM, Blogger shazza said...

Thank God I'm not alone! I've been having this for three nights now every time my head hits the pillow.
Before this week, I used to occasionally get it while watching the Simpsons- Lisa Simpson's high-pitched voice would set off the flutter! I would have to turn the sound down!
The night-time flutters are a new thing and I've found that a hot water bottle on the ear eventually stops it and I can get to sleep. Either that or leave the TV on as background noise- that does the trick for me too.
Such a wierd condition! Hopefully it'll just go away on its own. I sing in a rock band but never have it during a gig. Odd.

 
At 7:45 PM, Anonymous Anonymous said...

and i thought i was crazy. guess not i've been having these symptoms for about a week i havent found any thing to make it go away even muscle relaxers! Its really hard to sleep

 
At 3:56 AM, Anonymous Nicole said...

wow! This is exactly what has been going on with me since I had back surgery 2 weeks ago! Not sure if the Doc moved some nerves around in there, but it wakes me up btwn 4 and 6 am everyday and continues all day. Its horrible! Seeing the surgeon Tues for a follow up. Hope he can refer a good ENT. Thanks1

 
At 3:58 AM, Anonymous Nicole said...

r u my surgeon?? Where do you live? lol

 
At 8:14 AM, Blogger BreenDad said...

Hey folks
I have this type of middle ear myoclonus going on right now. It is annoying. I do have a crick in my neck, so the post by the chiropractor is very interesting indeed...anyway, I have found that putting an earbud headphone into my ear completely stops this problem - until I remove it. I am going to the drug store to purchase some foam earplugs. I think I will cut one down to a 1/3 of the original length, and bore a hole through it (before it is in my ear) to still be able to hear. I will then cover my ear with my hair and nobody will see it. Hopefully it resolves itself in the near future.

 
At 4:20 PM, Blogger hoggwash said...

I am experiencing this same thing! I felt like a crazy person... until I found this posting! Please tell me this will go away. It is so annoying!!! I have to take a flight on Friday, do you think this will cause pain during the airplane ride??
Thanks!!

 
At 2:26 AM, Blogger Sharon Cannings said...

Mine went away after four days and I haven't had it back (touch wood) since. Only the occasional brief flutter but it doesn't stay, thank goodness.

 
At 10:12 AM, Anonymous Nyle G. T. said...

ok - we all agree we are not alone. I remember the night my ear flutters started. In addition to the fluttering, my neck muscles feel like they are exhausted and I start to have a shaky feeling starting about noon time. Even though it is not visible, I feel it. I am a CPA and I do deal with a lot of stress, and I work on a computer every day. My fluttering has been going on almost 3 years. I have tried anti inflammatory, muscle relaxers, and a slew of vitamins. Some help, but nothing "fixes" it. I have seen an ENT, a orthopedic doctor, general practitioner, and a physical therapist. Has anyone found a treatment that works?

 
At 10:12 AM, Anonymous Nyle G. T. said...

ok - we all agree we are not alone. I remember the night my ear flutters started. In addition to the fluttering, my neck muscles feel like they are exhausted and I start to have a shaky feeling starting about noon time. Even though it is not visible, I feel it. I am a CPA and I do deal with a lot of stress, and I work on a computer every day. My fluttering has been going on almost 3 years. I have tried anti inflammatory, muscle relaxers, and a slew of vitamins. Some help, but nothing "fixes" it. I have seen an ENT, a orthopedic doctor, general practitioner, and a physical therapist. Has anyone found a treatment that works?

 
At 4:06 AM, Anonymous Anonymous said...

I have had this middle ear myoclonus on and off for nine years. It never disrupted my life before now. My episodes were short, never lasting more than 2 weeks, and did not disrupt my sleep at all. I had staccato drum roll clicking, over 200 clicks per second in response to running water and other external stimmuli, It was extremely annoying, but an ear plug cleared it right up, until the episode disappeared completely. Then it would go away for years, maybe 2 years at a time. This episode, however, is very different. It started on Feb 13 and lasted two weeks, until it almost went away with regular visits to a Physical therapist for head and neck manipulation. Then a stress even occurred in my life and wow, it is on full force again, but this time, I am getting clicking all day and all night long. I have not slept in a week, and it's hard to get through the days. I have taken .5 mg Ativan at night which doesn't touch the clicking. I am very scared that my life as I know it is over, because I cannot live like this. I read an article about Carbamazepine or other epileptic drugs, but I am very scared to take these. My last resort is the sectioning of these muscles. To the chiropractor who blogged. What state are you in?????????? Someone please help.

 
At 6:04 AM, Blogger Sue said...

I have had this little drummer in my ear for months. It started while on summer vacation and certainly was not tied to stress. It occurs in my left ear nightly and sometimes during the day. It does not seem to be triggered by any external stimuli. The ENT suggested I get off caffeine. I drink one or two diet cokes daily. I did, no luck. A recent prescription of muscle relaxers for a back injury did not relieve the thumping. I do take allergy medication. A blogger at another sight said she found some relief taking magnesium supplements (at her doctors recommendation). I'll give it a try. This little drummer is driving me nuts!

 
At 6:04 AM, Blogger Sue said...

I've been dealing with the annoying drummer in my ear for months. Mostly at night but sometimes in the day. It started while totally relaxing on summer vacation- no stress there. Recent prescription of muscle relaxers due to back injury did not help. I have a diet coke once or twice a day. Cut that out for two weeks.. no change. Someone on another blog suggested dehydration due to medication and caffeine might play a role. Another person's doctor prescribed magnesium supplements and that helped. I'll try that next. That little drummer in my ear is driving me NUTS!

 
At 10:32 PM, Anonymous Anonymous said...

i have bulging disc all through my neck bone spurs and pinched nerves coming from spine if i touch the back of my head where occipital nerves are tight and inflamed my eardrum will flutter i do assume that my tinnitus and eardrum flutters are because of my neck! i went mths.thinking i had something wrong with my ears but it turned out to be the neck i am scheduled for surgury so this should stop as soon as angry nerves are no longer pinched! i hope this helps someone. good luck to every one!

 
At 7:10 AM, Anonymous Anonymous said...

I'm so glad I found your blog. I've been having these ear flutters for several months. At first I tried to ignore them, but can't now. I wondered if a bug was in there trying to beat its way out and then I figured it probably wasn't, because surely it would have died by now. I was thinking of going to the doctor as I was worried it might be something serious. Now I think I'll just try to wait it out.

 
At 3:06 PM, Blogger kim said...

My right ear flutters sometimes when I'm standing at the sink running water. it doesn't seem to happen any particular time of day, but it is like there is a tiny bird flapping around in my ear. It doesn't hurt at all. If I turn the water off, it stops. What is going on? Should I get it checked?

 
At 7:37 PM, Anonymous Douglas Hoffman said...

Hi folks,
As you can tell, the boogers blog has long since gone defunct. I have no idea what my username or password were for this blog! But if you follow the URL on my name, you'll be able to trace back to the newer medical blog, which I actually pay attention to. Mostly.

 
At 12:45 PM, Anonymous Anonymous said...

For over TWO AND A HALF YEARS now I have been suffering from middle ear myoclonus, mostly in my right ear, but sometimes in my left. I've been to so many doctors it's ridiculous. And most have been nothing but worthless. And I'm in Boston, where you can't throw a stone without hitting a so-called "world-renowned" hospital. Forget Mass Eye and Ear -- the ENT I saw there was ABSOLUTELY USELESS! I told him it had gotten so bad that I was suicidal -- he referred me to a psychiatrist who didn't have any openings in her schedule for the next THREE YEARS!! What a f--king joke. If you are an ENT and you are reading this -- if a patient comes to you with middle ear myoclonus and you don't know much about it, please ADMIT IT and tell them you can't help them. Don't charge them for the visit. And if you are a patient -- DON'T LET THEM SIMPLY CUT YOUR TENDONS -- what is this, the middle ages??? Well, I ended up in a psycho hospital for a little while because I was going to kill myself. I'm on tons of drugs that don't really seem to help. I've recently seen a jaw specialist and an oral surgeon -- the oral surgeon of all people seemed to know more about MEM than all of the ENT's that I saw combined. DID YOU HEAR THAT, ENT'S??? You've been one-upped about an ear issue by someone who doesn't even specialize in ear disorders! Get a goddamn clue, all you rotten so-called ear doctors -- consider that maybe there is something physical going on that's causing the MEM -- don't just tell your patients that they are just stressed-out. Right now it looks like my MEM could be caused by TMJ/TMD (temporo-mandibular joint/temporomandibular joint disorder or dysfunction). I think we're going to try a mouth-guard to see if it helps. MEM is a miserable miserable condition that I would not wish on anyone, except maybe terrorists or child molesters.

 

Post a Comment

<< Home