Talk:Middle ear myoclonus

Lead

• Use common terms instead of "etiology", "idiopathic" and "pharmacotherapy".
• Something from the Epidemiology section can be included as a sentence or half a sentence.
• The image should be captioned.
• I am not sure if distinguishing MEM into types (stapedial myoclonus and tensor tympani myoclonus) is supported by sources.
• Use the "treatment" parameter instead of "medication"; instead of listing specific medications, please list the class of medications unless there is a specific medications that works better than others in the class (which does not appear to be the case); also add botulinum toxin injection and surgery to the parameter.

Signs and symptoms

The section appears to be too brief. This is a short article about a disease we probably do not have a lot of descriptive text or a wide variety of symptoms for, but we can certainly say more.

• It is worthwhile to explain what "myoclonus" means first.
• The text should elaborate on what "objective" tinnitus means.
• "A sensation of muscle contractions may also be present" — where is this generally felt?
• Per the sources cited, symptom onset is associated with stressful life events and forceful eye closure, which can be added.
• Żyżyńska et al. mentions pain as a prominent symptom. The paper also suggests that sensations are typically not constant and that they come and go; they also vary in intensity. Additionally, overall the symptoms are usually unilateral. All these are great points that other sources echo — all worth adding to this section.

Diagnosis

This is a fine section but needs some fine tuning (pun intended).

• Can "acoustic reflex decay testing" be explained in layperson terms?
• "Pulsatile tinnitus produces a rhythmic whooshing or thumping sound that matches the heartbeat. It is typically vascular in nature and unrelated to MEM" strays away from the topic. Explaining how pulsatile tinnitus is different while not explaining how palatal myoclonus is distinct seems less intuitive because the latter is a more similar condition.
• "Hypertrophy of the muscles may be detectable when analyzed with temporal bone CT scans." — "hypertrophy" should be stated in common terms. Which muscles? How is this "analyzed" and does this diagnose the condition or just suggest MEM?
• Eustachian tube pathologies should also be on the differential.
• Żyżyńska et al. has a great section on what is typically excluded while diagnosing this condition, some of which can be incorporated into this section.

Causes

• I am not sure if "spasms" is the right term to use which is too specific and I am not sure if that's the right descriptor based on review of sources cited in here and elsewhere. Please consider using "repetitive contractions", "repetitive abnormal movements" or similar instead.

Management

This is well-written, covering all important points.

• "Other medications tested for treatment" is phrased awkwardly. This can be phrased as "Other medications such as ... have been tried".
• I am not sure what "The safety profile of the procedure has not been established" means, especially because the source cited seems to focus on the fact that it appears to be a safe procedure.
• "This involves sectioning the tensor tympani and stapedius tendons" — we should use layperson terms instead of "sectioning".
• "There have been reports of the tendons reattaching through scar tissue after the operation, requiring a revision of the procedure" — I am uncertain if "reports" in plural form is accurate. As per the source listed, there appears to only be 1 reported case and I was not able to find cases requiring revisions in other sources but happy to be corrected.
• "This may be avoided by resecting a portion of the tendons rather than simply sectioning them." — I was not able to verify this based on the sources cited in this section. I may be missing this and okay with keeping this if you can point to me where this is mentioned.
• Using "complication(s)" instead of "side effect(s)" is more accurate.

Epidemiology

• "frequent misdiagnosis" — I am not sure if the source cited here states that. I may have missed it and am happy to be corrected, but otherwise this needs a better source or needs to be taken out.
• Stylistic preference but we can try to avoid ending a sentence with a term and beginning the subsequent sentence with the same term: "MEM. MEM".

References

• Park et al., Bhimrao et al., Kim et al., Lim et al., Hutz et al., Moon et al. and Khandalavala et al. should not have their titles in title case, and should be in sentence case.
• Park et al., Bhimrao et al., Kim et al., Hutz et al., Moon et al. and Khandalavala et al have restricted access and the citation should note that.

In summary, this is a short article about a topic we don't know much about. The article does well in covering its most important aspects. — Strange Orange | 21:46, 19 July 2026 (UTC)

Nehemiah McAfee, I am happy to keep this open until the end of August or longer if you need. Let me know; there is no time pressure. — Strange Orange | 19:30, 27 July 2026 (UTC)

I will be failing this unfortunately. The article is probably close to meeting the criteria but needs some work. Please feel free to re-nominate it after addressing the issues detailed above. — Strange Orange | 12:54, 28 August 2026 (UTC)