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    Problem unknown to the ear in France
    Freevox posted:
    Hello Dr. Rod Moser, Hello to all ...

    I call Nicolas and I am French, I use google translate to translate my text, I hope it will be understandable.

    I would write to you because I am at an impasse regarding a diagnosis for a problem with my right ear. Having hundreds of kilometers in France looking for a specialist, I decided to write to you to see if you could help me.

    I actually since the month of July 2012 a problem in the right ear characterized by vibrations of the eardrum and crackling sounds at the end of my sentences or in response to certain sounds (door slamming, dishes clattering that , applause ...). I do not feel no pain, just this very disabling. You should know that I've had a few years of sudden deafness in the right ear repetition, the last date of September 2011, every time my hearing is still completely restored. I feel that the sensitivity of my eardrum to start this time with the vibrations felt on certain sounds. I had an MRI in search of a neuroma that does nothing.
    - For cracking my problem I consulted my ENT referral hospital of Saint-Quentin in July 2012 (Aisne) that I was diagnosed with stapedial muscle spasms or hammer treatment with magnesium and relaxing muscle. After 15 days of treatment, I did not feel any improvement. The ENT did not offered other treatments.
    - So I made an appointment with a neurologist Professor in Paris in September 2012 (Pr Marie Vidailhet), which is in the same approximation when speaking of the stapedius muscle myoclonus or tensor tympani but no offer of treatment.

    - My doctor then offered me a treatment test with RIVOTRIL, 5 drops in the morning and 5 drops in the evening (I went up to 10 drops morning and evening) without seeing any result, until one day, current mid-January 2013 my symptoms have disappeared completions for 1 month and a half.
    My doctor no longer has the right to prescribe the RIVOTRIL in France, I had to lower the dose to stop (crackling in my ears right now reappeared for 3 weeks). Is Rivotril play a role?

    - Meanwhile I met another ENT Professor, beginning in January 2013 (Pr CHAYS - Hospital of Reims), it is not convinced that my problem is muscular order for him crackling sound that j ' mean the end of all my sentences does not resemble myoclonus. He prescribed a 6 month basis FLUIMICIL (3 sachets to take 1 month to 2) and a scan of the rock cut ultra-thin (Nothing abnormal visible on the results of scanner) I shall review the Pr CHAYS in July to give the result of the scan and the results of its treatment. Knowing that cracks have disappeared for 1 and a half months that I start FLUIMICIL.
    - I have since the beginning of the week starting treatment with VALIUM (2 drops morning and evening without climbing gradually exceed 10 drops morning and 20 at night).
    I know it is impossible to confirm a pathology distance but as you are a size in the middle and you're hundreds of miles from home, I wanted your opinion whether my symptoms are actually become a problem in the inner ear muscle or myoclonus? Or as suggested by Professor CHAYS, maybe a problem is the Eustachian tube? or something else?

    Concerning the examinations already carried out:

    Blood in search of autoimmune diseases of the ear, hearing tests battery (impedance test auditions ...), doppler ultrasound, radio-cervical spine, scan and ATM ROCK, MRI all is OK.

    I am sorry to see that the greatest experts in the field (which you party) are abroad. Would you have some therapeutic guidelines advise me to get out of this nightmare? In advance, thank you for your help.

    Waiting to hear from you,
    Rod Moser, PA, PhD responded:
    Those three tiny ear bones in your middle ear (the area on the other side of your eardrum) have muscles (the stapedial and tensor tympani muscle) that are attached to them. Like any muscle, they can go into spasm and rapidly twitch (myoclonus). When this happens in the ear, it will cause the eardrum to vibrate like a drum, resulting in a clicking or even a machine-like sound. The muscles in the throat and palate (the tensor veli palatini muscle) can also be contributory.

    Myoclonus, assuming this is what you have, is not an easy problem to fix. Surgery is sometimes performed to cut those muscles, or the muscle-paralyzing botulism toxin (Botox) is injected into them in an effort to correct more serious cases. An ENT sub-specialist (a neurotologist) is the best person to evaluate and manage this difficult-to-treat disorder.

    Your problem has been investigated quite thoroughly. I am impressed. Quite often, even after an extensive diagnostic work-up, a cause is never really found, so this is why your doctors are trying various treatments (treatments and medications, incidentally, that we do not use in the U.S.). Finding an effective treatment is really your mission right now, so be prepared for many trials of various modalities.

    I am sorry that I cannot offer you any more profound insight over the Internet, but I do wish you the very best.

    You have a beautiful first visit to France was last year. I hope to return many more times.....
    Freevox replied to Rod Moser, PA, PhD's response:
    Hello Doctor,

    Thank you for your reply, I could not believe it.

    Do you have to test several treatments before considering surgery.

    I had no crackling in my ear yesterday and this morning, it's strange, now they are back. Is that myoclonus can go some time before returning?

    Otherwise you can be what other diseases can cause crackling in my ear?

    Specialists not observe myoclonus of the palate or george.

    What may well cause its crackling uniquements when I speak with some or sound? other than myoclonus?

    Today I contacted an association specialized in tinnitus. I am not reassured, I was talking hyperacusis! No specialists I met ENT or Neurologist told me about hyperacusis. It seems strange to me because I feel better in noisy places (downtown - family meals)

    In France, I feel that I am a unique case, nobody is a sure diagnosis.

    France is indeed a beautiful country, where you going?

    Paris or something??? Tip: Visit Alsace (Strasbourg, Colmard, ..) and the North (Lille), winter and summer BRITAIN South.

    Thank you for your help, do you advise me to confreres in France?

    good day

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