Expert: Dina Q Goldin, Ph.D. - 11/3/2008

Question
About a year ago, I started having little muscle spasms in my left ear, usually in response to certain pitches (usually in music) and in large crowds.  

Around the same time, my right ear started to occasionally emit high-pitched beeping sounds (not ringing, like tinnitus, much louder and alternating back and forth btw two pitches in a minor third), most often when I was falling asleep (though sometimes it would wake me up in the morning).

My hearing has also gotten increasingly more sensitive, ie many more sounds are painful than they should be (sometimes even loud conversation will hurt a bit).

I got an MRI (normal, just a polyp in my sinus cavity), had a number of hearing tests (normal, with elevated sensitivity to sound) and visited an ENT specialist, who diagnosed the problem in the left ear as stapedial myoclonus and prescribed me Xanax to help alleviate the spasms.  The Xanax does help somewhat (the severity of the spasms is down, and it doesn't quite feel like I have a moth stuffed in my ear anymore), but now my right ear is going insane (and this is the reason I'm writing this question):

I have had life-long tinnitus, but in the last few weeks the tinnitus in my right ear has become overwhelmingly loud: the spells come in waves, and the louder the ringing, the more light-headed I become (it's nauseating), and the more numb I get.  The numbness starts around my right cheek, but during really bad episodes, I've felt numb all over, almost as if I'd had a few drinks (even my teeth feel funny!).  It has gotten to the point that I don't even feel safe to drive (I only take the Xanax when the spasms get bad, and that's not very consistently, so it's not the medication).  In addition, during the worst spells, my right ear feels like it is swelling up and closing (it feels full and shut up even though it looks fine), and my hearing out of that ear will be severely effected (it's tinny and sounds like a VERY bad cell connection).  

The episodes of ringing and dizziness seem to come on pretty randomly: They happen when I'm sitting watching tv, out doing errands, working at the computer... the only time I can guarantee an episode is when I work out (if I get my blood pressure to go up, it comes on with a vengeance and then stays that way for hours afterward). And needless to say, when the right ear is acting like this, the left ear becomes hyper-sensitive: it often feels like my entire left side of my head and neck is cringing/spasming in response to any sound stimulus. Sleep seems to improve the symptoms, and they are most often worse in the evening than the morning.

I am scheduled for another MRI a few days from now, but my doctor sounds like she's going the direction of an ENT reference again.  Because I can feel numbness in my neck and fingers and I've had long-term myoclonuses elsewhere in the last few months (left eye, abdomen, right shoulder blade) that have lasted for days at a time, I'm wondering if it's not some sort of nerve issue (is it possible that swollen blood vessels could pinch nerves, and that's why it's worse when I work out?).

Other factors: I am 32, overweight (175 lbs at 5'6) with elevated cholesterol (the weight gain is 40 lbs in 3 years, I just stopped using the Nuvaring just in case that was why), we recently (2 months ago) moved from 0 elevation to 7000, and I was diagnosed with fibromyalgia and a mild sleep disorder about 10 years ago.

I know this is long, but this is sort of taking over my life right now, and I'm feeling very frustrated and a little frightened.  Any help or advise you could give me would be greatly appreciated.

Answer
It sounds like a good idea to have another MRI.  Please make sure that it is (a) done with a contrasting agent (gadolinium) and (b) read by a neuroradiologist (radiologists are the people who actually study the MRI scan and prepare a report for your doctor, and neuroradiologists specialize in problems of the nervous system).  Also, since it does sound like a nerve issue, you may want to be working with a neurologist rather than an ENT.  They are more likely to be able to figure out what your problem is.