What is middle ear myoclonus (MEM)?

Middle ear myoclonus is a type of tinnitus, which is the perception of sound that doesn’t have an external source, often described as a ringing in the ears. This specific type of tinnitus is caused by a dysfunction in the movement of two muscles in the middle ear, the tensor tympani and the stapedius. When these two muscles begin contracting on their own, it can cause noises in the ear and sometimes it can even contribute to a feeling of dizziness. The good news is that middle ear myoclonus treatment is available and many patients experience relief after consulting with a doctor or hearing specialist.

What are symptoms of middle ear myoclonus?

If you hear crackling, clicking, fluttering or thumping noises in the ear, you might have middle ear myoclonus. The symptoms may arise for no apparent reason, or they could appear or intensify because of triggers like swallowing, speaking or changing your head position. Middle ear myoclonus symptoms can be so severe that they interfere with your ability to sleep.

Is middle ear myoclonus a symptom for other conditions?

MEM is a form of tinnitus, and its symptoms can lead to a diagnosis of other ear-related conditions. A number of health conditions are associated, including:

• Atherosclerosis
• Ear infection
• Head or neck injuries
• Hearing loss
• Hypertension

How is middle ear myoclonus diagnosed?

Doctors typically arrive at a middle ear myoclonus diagnosis after extensive testing. These tests might include:

• Clinical exams: Your doctor will check your general health and ask questions about your health history.
• Otoscopic examinations: Looking and listening in your ears may help your doctor discover signs of MEM, especially if spasms are happening enough to be seen and heard.
• Tympanometry: A tympanometry measures the movement of the eardrum, and it can also record reflexes from sound stimulation.
• Electromyography (EMG): This test measures the conduction of electrical signals by nerves that cause muscles to contract and relax, and it can pinpoint the spasm points of muscles.

Does Middle Ear Myoclonus go away on its own?

Middle ear myoclonus (MEM), in some cases, may resolve  on its own, especially if it is triggered by stress, fatigue, or temporary irritation. However, for many individuals, the condition becomes chronic or recurrent, and spontaneous resolution is rare  once symptoms persist for an extended period. Because MEM is so rare and its exact cause is often unclear, treatment options vary. 

Some people find relief through lifestyle changes such as reducing stress, improving sleep, or using sound therapy. Others may require medication (e.g., muscle relaxants or anticonvulsants) or even surgical options if symptoms are severe and persistent.

If you experience unexplained clicking or fluttering sounds in your ear, it’s important to consult an ear, nose, and throat (ENT) specialist. Early diagnosis can help manage the condition more effectively and rule out other causes of ear-related noise.

Is Middle Ear Myoclonus dangerous?

Middle ear myoclonus (MEM) is typically not dangerous, but it can be very disruptive and distressing for those who experience it. While MEM does not damage hearing or lead to serious health complications, it can significantly affect a person’s quality of life. The persistent noise can interfere with concentration, sleep, and emotional well-being, especially if symptoms become chronic. The condition itself is not life-threatening and  typically does not indicate a more serious underlying illness. However, in some cases, MEM may be associated with other neurological or muscular disorders, or it may be triggered by stress, fatigue, or trauma to the ear area.

If symptoms are severe or prolonged, it's important to see an ear, nose, and throat (ENT) specialist. While MEM isn't considered dangerous, proper diagnosis and management can help reduce the impact of the condition and rule out other potential causes of similar symptoms.

Are Middle Ear Myoclonus and anxiety linked?

Middle ear myoclonus (MEM) and anxiety can be closely linked. While the exact cause is often unknown, stress and anxiety can increase awareness of these internal sounds or even trigger or worsen the muscle spasms. People with heightened anxiety may be more sensitive to subtle bodily sensations, including ear-related noises.

Caffeine—a known stimulant—can also contribute to MEM by increasing nervous system activity and muscle excitability, especially in individuals who are already anxious. Reducing or eliminating caffeine intake may help alleviate symptoms in some cases.

There is also a possible connection between MEM and Eustachian tube dysfunction (ETD). ETD can create pressure imbalances and discomfort in the ear, which might irritate the middle ear muscles and contribute to or mimic MEM symptoms.

Though rare, MEM has also been observed in patients with neurological conditions such as multiple sclerosis (MS), but this is uncommon. If you’re experiencing persistent ear noises, especially alongside anxiety, ETD, or other neurological symptoms, it’s important to consult an ENT specialist and consider a broader medical evaluation.

Is Middle Ear Myoclonus permanent?

Middle ear myoclonus (MEM) is not always permanent, but it can become chronic or long-lasting in some individuals.

In some cases, MEM is temporary and may resolve on its own, especially if it’s triggered by stress, fatigue, caffeine, or temporary irritation of the ear. Lifestyle changes, stress management, and avoiding stimulants can help reduce or eliminate symptoms in these situations.

However, for others, MEM can be persistent or recurring, and symptoms may last for months or even years without intervention. While the condition is not harmful or life-threatening, it can significantly impact quality of life, especially when it interferes with concentration, sleep, or emotional well-being.

Treatment depends on the severity and cause. Some people find relief with medications, sound therapy, or physical therapy. In severe, treatment-resistant cases, surgical intervention, such as cutting or removing the affected middle ear muscle, may be considered.

What does Middle Ear Myoclonus sound like?

Middle Ear Myoclonus (MEM) produces distinct internal sounds caused by the rhythmic, involuntary contractions of the small muscles in the middle ear—typically the tensor tympani or stapedius.

People with MEM often describe the sounds as:

• Clicking: Sharp, repetitive, or irregular clicks that may occur in bursts or continuously
• Fluttering: A rapid, vibrating sensation similar to a butterfly flapping its wings
• Thumping or popping: Dull, rhythmic taps or thumps, sometimes felt as well as heard
• Drumming or tapping: Patterns that may mimic a heartbeat or a pulsating sound
• Rustling or crackling: Soft, repetitive noises, especially noticeable during quiet moments

These sounds are typically heard only by the person experiencing them (called subjective tinnitus), but in rare cases, they may be audible to others (known as objective tinnitus) during a medical exam.

MEM sounds can occur in one or both ears and may change in intensity, frequency, or pattern. They often become more noticeable in quiet environments and may worsen with stress, fatigue, or movements such as chewing, swallowing, or yawning.

Less known Middle ear myoclonus treatments

How to stop eardrum or muscle spasms in the ears? Fortunately, there are several treatment options available to help manage or stop the twitching and muscle spasms. Initial treatments often include lifestyle changes and stress reduction, as anxiety and fatigue can worsen symptoms. Some patients find relief by reducing caffeine intake and improving sleep habits. Magnesium supplements may also help, as magnesium supports healthy muscle and nerve function and may reduce spasms in some individuals.

Doctors may prescribe muscle relaxants or anticonvulsant medications to help calm the involuntary contractions. In some cases, Botox injections have been used off-label to reduce muscle activity.

If conservative treatments fail, middle ear myoclonus surgery may be considered. This procedure involves severing or removing the affected muscle to permanently stop the spasms. While effective, surgery is typically reserved for severe, treatment-resistant cases.

Middle ear myoclonus and related symptoms

Some people also experience sensations like an eardrum twitch or spasms, which can be brief or ongoing. Though MEM doesn't typically affect balance, in some cases it may contribute to dizziness, especially if the spasms disturb inner ear function or are accompanied by Eustachian tube dysfunction. Eustachian tube problems may cause pressure changes, crackling sounds, or a sense of fullness in the ear, which can aggravate MEM symptoms.

MEM may also overlap with tensor tympani syndrome, a condition where the tensor tympani muscle overreacts to sounds or stress, causing ear discomfort, fullness, or spasms.

To help stop eardrum spasms or twitching, treatments may include magnesium supplements, muscle relaxants, or stress-reduction techniques. In more severe cases, Botox injections or even middle ear surgery may be considered to sever the overactive muscle.