A Case Study in Rhythmic Tinnitus Relief
By David Lee L.Ac.
Myoclonus syndrome is a neurological condition characterized by sudden, brief, involuntary muscle jerks or spasms. Inner ear myoclonus, specifically middle ear myoclonus (MEM), refers to involuntary, rhythmic contractions or spasms of the middle ear muscles, primarily the tensor tympani and stapedius muscles, resulting in clicking, buzzing, or fluttering sounds in the ear. These sounds are often described as objective tinnitus, meaning they can be heard by both the patient and the examiner.
MEM is thought to be caused by abnormal nerve impulses or nerve damage in the middle ear, leading to muscle spasms. It can be associated with various conditions, including viral infections, middle ear infections, and even psychological factors like anxiety.
The primary symptom of MEM is the perception of rhythmic, clicking, buzzing, or fluttering sounds in the ear. These sounds can be quite disruptive and may affect sleep.
- Clicking, thumping or buzzing tinnitus
- Sensation of fluttering in the ears
- Sharp pain in and around the ear
- Dull ache in the ears
- Sensation of pressure or blockage in the ears
- Pain, numbness or burning sensations aroundthe ear
- Mild vertigo
- Nausea
- Headaches
- “Muffled” or distorted hearing
While there’s no cure for middle ear myoclonus (MEM), treatments range from medications like muscle relaxants and anti-seizure drugs to surgical interventions like tenotomy, and even Botox injections.
Case Summary
David B., age 63, finance
The patient has experienced left ear myoclonus syndrome for the past five years, with symptoms progressively worsening over time. Anti-seizure medications were ineffective. The patient reported that inserting a finger into the left ear canal temporarily reduced symptoms. Clinical observation confirmed visible contractions.
Subjective symptoms included a persistent sensation of a “ball” in the ear, along with vibration and pulsation radiating through the left side of the skull. These sensations were overwhelming and disruptive throughout the day. The condition interfered with sleep, making it difficult to fall asleep and caused the patient to wake around 3–4 a.m. each night, often with increased symptom severity and difficulty returning to sleep.
Acupuncture was initiated using Yang Horary points based on the Metal Order on both the left and right sides: ST36, SI5, GB41, UB66, and LI1. Additional Fire points—LI5, GB38, and UB60—were included based on the patient’s Sasang constitution (Taeeumin), temperament (Choleric in Four Temperaments), Ayurvedic profile (Pitta-Kapha), and Myers-Briggs type (ESTP).
A few hours after the first Metal Order treatment on the left side, the patient reported a noticeable reduction in symptoms. Improvement continued after the second session. The addition of Fire points from the third treatment showed further enhanced the relief. With ongoing acupuncture sessions administered two to three times per week, especially with the bilateral acupuncture, the patient experienced steady weekly improvement.
By the 20th session, the patient reported approximately a 70% reduction in the intensity, frequency, and duration of symptoms.
Symptoms are still most pronounced around 3–4 a.m., though the patient is now able to return to sleep more easily. Continued treatments are expected to either stabilize the condition further or provide additional symptom relief.
