Middle ear myoclonus: Causes & treatment

Last update on Jul, 30, 2025

What’s that sound you’re hearing? If you’re suffering from middle ear myoclonus, noises may be coming from inside your body, not the outside world. Sounds like crackling, clicking or thumping within your ears might be a sign of middle ear myoclonus, also known as MEM. Learn more about the symptoms of this rare condition and discover common causes and approved medical treatments.

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.

What are the causes of middle ear myoclonus?

Curious about what could lead to this unusual condition? Learn more about some of the most common middle ear myoclonus causes:

Middle ear myoclonus causes like genetics might include a family history of the condition, which could make you more likely to experience it at some point in your life.

Your environment can lead to the onset of MEM. If you’ve had prolonged exposure to loud noises, your tensor tympani and stapedius muscles might become damaged, resulting in this form of tinnitus.

Middle ear myoclonus and allergy symptoms are also linked, especially when the allergies are seasonal. Those who suffer from allergic rhinitis, sometimes known as “hay fever,” can have such severe symptoms that it causes or worsens tinnitus-type symptoms.

If you’re prone to muscle spasms in other areas of your body, you might experience symptoms related to MEM. Stapedius and tensor tympani muscle spasms can disrupt the function of the ossicles, which are three tiny bones in the middle ear. That disruption can lead to the sound and balance issues associated with MEM.

The muscles that open the Eustachian tubes, called the tensor veli palatini, are connected to the tensor tympani muscle in the middle ear. A pressure imbalance in the middle ear can occur when the tube doesn’t open correctly, and that Eustachian tube dysfunction can lead to symptoms of MEM.

Chronic middle ear infections can cause inflammation, which could eventually result in a MEM diagnosis.

The temporomandibular joint (TMJ), which is in your jaw, is physically very close to your middle ear. If you’re having problems with spasms in the muscles around that joint, the function of the middle ear muscles could also be adversely affected, resulting in MEM symptoms.

Be sure to talk to a healthcare professional about your symptoms, which can be exacerbated by certain medications. If you’re taking certain antibiotics, they may play a role. Other middle ear myoclonus causes include illicit drug use of stimulants like cocaine or amphetamines, which can have a negative impact on the function of the middle ear.

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
Woman with tooth an ear pain

Prevention is key

Never underestimate the importance of ear care. Your hearing might depend on it.

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.

Middle ear myoclonus treatment

Middle ear myoclonus treatment can include:

  • A surgical procedure known as tensor tympani tenotomy is one option for middle ear myoclonus treatment. It involves cutting the tensor tympani muscle to eliminate spasms.
  • Another procedure is a tympanotomy, which creates a hole in the eardrum to release pressure on the middle ear.
  • Removal of the stapes bone in the ear and the implant of a prothesis is another option. This procedure known as a stapedectomy. With MEM, the stapes bone can sometimes stick in place, which decreases the ability of sound to be carried across to the inner ear. Removing the stapes bone and implanting a prothesis can help with hearing function by opening that access.

Non-traditional middle ear myoclonus treatments are also available. Alternative and integrative therapies like acupuncture, biofeedback, yoga and meditation are also common middle ear myoclonus treatments. The focus on the free flow of breath and the awareness of energy within the body can offer relief from the spasms and inflammation of MEM.

Some people find relief from MEM and other forms of tinnitus in cognitive behavioral therapy (CBT). This form of talk therapy helps you to develop skills and techniques to cope with the symptoms.

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.

HCP at store

Check your hearing with Miracle-Ear

One of the best ways to care for your ears and prevent hearing loss is to get them properly examined by a hearing professional. Find your nearest Miracle-Ear store to get started on your journey to better hearing.

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 rareMEM 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.

Find your closest Miracle-Ear center

Your store

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.

girl with tablet

Try our free online hearing test

Take a free online hearing test now. Your first step to better hearing is only a click away! In less than five minutes, you'll have a better understanding of your hearing health.

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.

Frequently asked questions about Middle Ear Myoclonus

For patients who have middle ear myoclonus, Botox injections can reduce the frequency of spasms and alleviate some symptoms.

The tensor tympani is a muscle located in the middle ear, which sits near the stapedius muscle. If you’re dealing with MEM, stapedius and tensor tympani muscle spasms are likely the reason you hear a clicking or fluttering sound in your ears.

If you’re experiencing middle ear myoclonus symptoms, especially if they’re affecting your sleep and everyday life, consider consulting with a doctor, who can recommend proper middle ear myoclonus treatment options.

If MEM is affecting your hearing, consult with your primary care physician or ENT. They may recommend a visit to a Miracle-Ear Hearing Center, where a hearing care professional can examine and determine if this could be associated with hearing loss

More from the blog

Discover a world of sounds.
View all

Get support and advice

Book an appointment online

Book now

Take a free online hearing test

Start test

Find a hearing aid center near you

Search now