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What Causes Muscle Fasciculation And Mild Mitral Valve Prolapse With Dysrhythmia?

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Posted on Thu, 23 Jul 2015
Question: I have been hearing twitches in my ear. It comes and goes. Mainly on the right ear. It has been constant the past hour, though. I rarely have fasciculations. Every once in a while I feel muscle fasciculation but very rarely (like once every year). Right now I'm being teated by PT for pain and spasms on my upper back, mainly the right side. However, the fasciculations in my ear started this month. Once every 2 weeks. And they are not as fast as it is now. Was 3 thumps per second, every 2-3 minutes and lasts for half an hour. Now it's been more than an hour and it's faster: 3 thumps per second every 30 secs.

Additional details: Medical hx includes hyperlipidemia, anxiety disorder x 12 years, depression x 4 years, CREST syndrome, mild mitral valve prolapse with mild and occasional (very rare) dysrhythmia, hx of BPPV. I am being treated by for upper back pain and muscle spasms, Xray results: very mild spondylosis and mild dextroscoliosis. Medications:Klor-con 10 MEQ QD
Propranolol 10 mg QD
Clonazepam 2 mg - TID prn
Meprobamate 200 mg TID prn
Zetia 10 mg QD
Mirtazapine 15 mg at bedtime
Pepcid 40 mg QD
Crestor 5 mg QD

Additional info I have been under a lot of stress lately.
doctor
Answered by Dr. Abubakar Siddiqh (7 hours later)
Brief Answer:
seems to be stress induced.

Detailed Answer:

Hi,

I had gone through your question and understand your concerns that you are having fasiculations in ear. I would like to ask you few more details.

Is there any associated hearing loss ?

Kindly get back to me with the details.


Based on your description, it appears to be myoclonus of middle ear muscles (stepedius, tensor tympani) secondary to psychogenic stress or anatomical anomalies or due to drugs (anti depressants).


I suggest you to follow these measures to overcome your ear related issues.


1. Stress free life style (stop the worry and the twitching will go away). Daily routine exercises- walking for an hour.

2. ENT consultation followed by special investigations ( audiometry- to see tensed muscles and associated hearing loss), BERA (BRAIN STEM EVOKED RESPONSE) AND MRI (to see any pathological lesions), EMG- (ELECROMYOGRAPHY- to see muscle abnormalities). Treatment can be started as per the findings.

3. Re consult your psychiatrist for altering the dosage of your daily medications.


Hope this answers your question, if you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.

Wishing you good health.




Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Abubakar Siddiqh (19 hours later)
Thank you for your advice. I'm quite sure it's stress-realted, or maybe even fatigue? No, I don't have HOH.

I exercise almost everyday. Cardios every other day and circuits on alternate days. However, I stopped working out since Saturday when my back pain got worse. I also stopped because I am being teated for Physical Therapy for my back pain and "rest and protect" for a couple of weeks was recommended. I'm a Physical therapist myself and I 'd rather err on the side of caution. I even stopped seeing patients because I don't want to injure myself, or worse, injure my patients (I do skilled rehab and see heavy and involved patients).

The ear fasciculations has stopped. I haven't had any today. Like I said it happens rarely and mostly when I'm fatigued or stressed out. However, i will talk to my MD about it and ask for Neuro or ENT referral if it goes back and gets worse.

P.S. My level of anxiety has gone down since yesterday and slowly getting better. It's work-related. I'm leaving the job and will do what I really love to do. :-) I will also ask my psychiatrist about the antidepressant. I know my medication profile seems too much, but they kept me alive in the past 8 months when I left the job that I loved (teaching) to venture into one that makes more money. I have been in a constant state of anxiety since November of last year. I will be going back to being a professor effective July. Thanks again for your advice.

Forgot to tell you. The back pain tends to radiate to my right arm and back of my head. I also feel ear pain every once in a while. I feel like they are all connected. My traps and neck muscles are really tight. Also tight pectorals. Poor posture- head forward and I slump a lot.
doctor
Answered by Dr. Abubakar Siddiqh (3 hours later)
Brief Answer:
spondylosis- restrict neck movements.

Detailed Answer:

Hello again,


Thanks for considering my answer and for your follow up.

Your symptoms are suggestive of spondylosis (pain radiating to arm and neck)and mild dextroscoliosis.

Restricted neck movements, wearing soft collar, physiotherapy and posture maintenance during sitting and driving will give relief from the symptoms.

All the best. Take care.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
Dr.
Dr. Abubakar Siddiqh

ENT Specialist

Practicing since :1994

Answered : 2038 Questions

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What Causes Muscle Fasciculation And Mild Mitral Valve Prolapse With Dysrhythmia?

Brief Answer: seems to be stress induced. Detailed Answer: Hi, I had gone through your question and understand your concerns that you are having fasiculations in ear. I would like to ask you few more details. Is there any associated hearing loss ? Kindly get back to me with the details. Based on your description, it appears to be myoclonus of middle ear muscles (stepedius, tensor tympani) secondary to psychogenic stress or anatomical anomalies or due to drugs (anti depressants). I suggest you to follow these measures to overcome your ear related issues. 1. Stress free life style (stop the worry and the twitching will go away). Daily routine exercises- walking for an hour. 2. ENT consultation followed by special investigations ( audiometry- to see tensed muscles and associated hearing loss), BERA (BRAIN STEM EVOKED RESPONSE) AND MRI (to see any pathological lesions), EMG- (ELECROMYOGRAPHY- to see muscle abnormalities). Treatment can be started as per the findings. 3. Re consult your psychiatrist for altering the dosage of your daily medications. Hope this answers your question, if you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.