What's the Difference Between TTTS and MEM?

[japongus]

I've read @Chelles and @Blackbird26 say this, something like ''are you sure its not TTS'' to other users. Did they mean tensor tympani spasms as opposed to stapedial spasms? Or did they mean that TTS, as in tonic tensor tympani syndrome responds to external sounds whereas myoclonus goes off on its own? And if so, have any doctors with experience said this?

I assume you can have both, but am I wrong?

 

[PaulBe]

MEM is a blanket term. TTS vs Stapaedial myo is breaking it down to "which one". I've no doubt you could have either or both, either as a reactive condition, or as a random myoclonic episode. The question still seems to be "which one feels/sounds like what". Its kind of like epilepsy where there can be a known trigger, or there can simply be random firing. Nerves drive muscles, or muscles drive nerves?

 

[lapidus]

I always assumed that thumping/fluttering that can be felt near the eardrum and is triggered by sound is TTS.

 

[PaulBe]

I always assumed that thumping/fluttering that can be felt near the eardrum and is triggered by sound is TTS.

It is. Its also a presentation of myoclonus in that its a spasming muscle in action. Myo=muscle, clonus=spasm (rhythmic contraction). I've had symptoms consistent with Tensor tympani over-activity but sound as a trigger for it tends not to be there. That's one reason I wonder if its actually stapedial myo that I get, and whether it contributes to my particular brand of tinnitus.

 

[japongus]

I always assumed that thumping/fluttering that can be felt near the eardrum and is triggered by sound is TTS.

Well that's one thing. The next is to make the jump to see if it's not protecting anything at all and its extraction would actually free the patient from most if not all the pain. That's not even slightly evident in anything doctors have officially said on the matter, and there are strong proponents against its logic, both mainstream and sound therapy logicians.

All I have are vague statements, or maybe not vague at all, maybe just they take it for granted, from some docs in the pulsatile tinnitus community.

@PaulBe I like your epilepsy analogy or likening to epilepsy. I was thinking more along the lines of a contracted state of one component provoking the sound induced pulsatile state of the other. So for instance, Lib remained with low frequency vibration after the surgery, but her ass was saved cuz no more vibrations to sound.

 

[japongus]

It is. Its also a presentation of myoclonus in that its a spasming muscle in action. Myo=muscle, clonus=spasm (rhythmic contraction). I've had symptoms consistent with Tensor tympani over-activity but sound as a trigger for it tends not to be there. That's one reason I wonder if its actually stapedial myo that I get, and whether it contributes to my particular brand of tinnitus.

So you're saying your tensor overactivity comes with sound and without it? I've had thumps that weren't sound provoked, rarely though but I've had them, and they were different from my usual sound provoked thumps, they seemed more on the surface. One of the problems I see in TTTS or stapedial myo is it could be reactive tinnitus of inner ear that just happens to be of low sound, so the cochlea or the brain despite not having any muscles involved, could be producing sound that's takes a feelable dimension because of its frequency. Still, I get an echoish feel to the thumps as if they really are in a cave bouncing around so I'm not quite onto how that model would be doing that too.

 

[PaulBe]

Well...I suppose I am, and in a way I'm channeling the Jastros here, but sound probably only has to be anticipated to trigger an autonomic response once one has taken enough of a hyperacusic beating. Jastrebof, meet Pavlov.

so the cochlea or the brain despite not having any muscles involved, could be producing sound that's takes a feelable dimension because of its frequency

I think this is very likely my case. Certainly with damaged nerves some cross-talk can occur if a stimulus is strong/deranged enough (smelling colours, seeing music as images). I was for a time feeling sounds running across my maxilla. I'm tending these days to think there's a one-two punch factor happening to a lot of us involving muscles and nerves, but I'm still unsure which provokes what first, and also, we no doubt have similar but different levels of damage so the reactions we perceive are equally similar but different.

 

[japongus]

Yeah I mean I don't really believe in ''reactive tinnitus'' in this case, not of lower frequency anyway. I mean, wasn't the whole logic of hearing loss that it had to happen at higher frequencies first...

I consider it and think the possibility through, but there's already precedent in Lib and JoeM and it would be really odd if there were also a purely sound auditory non-muscular movement vibration touching going on that just so happens to be so similar to cases already seen in Lib, JoeM or vasilia. Plus there's @AnxiousJon who went to a doctor that believes in this diagnosis, seemed to have spoken fairly confidently about it, and might have done a lot of these and talks of 60% of success rates.

But what if behind the thumps there's pain... like the pain that seems to be predominent in sufferers that tell me they have no touching rattling middle ground, that for them it's either pain or nothing, no pulling, no echoing no thumping... Sismanis seemed pretty confident or lazy and didn't give a crap when he seemed to see it as simply as if you get H after the op just go for window reinforcement too...