Transitory stapedial myoclonus in a patient with benign fasciculation syndrome

We report a previously undescribed association between transitory stapedial myoclonus, objective tinnitus and benign fasciculation syndrome. Case report and review of the world literature regarding stapedial myoclonus. A 30-year-old man with a diagnosis of benign fasciculation syndrome abruptly deve...

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Bibliographic Details
Published in:Journal of laryngology and otology 2013-06, Vol.127 (6), p.605-606
Main Authors: Brigo, F, Storti, M, Lochner, P, Nardone, R
Format: Article
Language:English
Subjects:
Adult
Clinical Records
Ears & hearing
Family medical history
Fasciculation - complications
Humans
Male
Myoclonus - etiology
Otoscopy
Stapedius - physiopathology
Syndrome
Thermometers
Tinnitus - etiology
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Summary:We report a previously undescribed association between transitory stapedial myoclonus, objective tinnitus and benign fasciculation syndrome. Case report and review of the world literature regarding stapedial myoclonus. A 30-year-old man with a diagnosis of benign fasciculation syndrome abruptly developed severe, low-pitched tinnitus on the right side. Otoscopic examination revealed rhythmic movement of the tympanic membrane, which was synchronous with the tinnitus. No palatal spasm was noted on nasopharyngeal examination. Brain magnetic resonance imaging and pure tone audiometry were unremarkable. Based on these findings, a diagnosis of objective tinnitus due to stapedial myoclonus was made. The objective tinnitus spontaneously disappeared within 48 hours of its appearance, but in the following days the patient suffered frequent, brief episodes of objective tinnitus lasting only a few seconds. The occurrence of stapedial myoclonus in this patient indicated the presence of an underlying motor unit hyper-excitability. This case suggests that, in some patients, stapedial myoclonus may represent the clinical expression of diffuse motor unit hyper-excitability.
ISSN:0022-2151
1748-5460
DOI:10.1017/S0022215113000297