Palatal myoclonus: A report of two cases

Pulec, Jack L.; Simonton, Kinsey M.

doi:10.1002/lary.5540710609

Cited by 47 publications

(20 citation statements)

References 7 publications

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“…A clicking sound at the time of onset of palatal myoclonus is a common feature, as was the case with our patient. This symptom is probably caused by alternate opening and closing of the eustachian tube by the tensor veil palatini (3,4). Often this clicking can be heard by the examiner, but this was not the case with our patient.…”

Section: Discussionmentioning

confidence: 60%

Palatal myoclonus: Treatment with 5‐hydroxytryptophan and carbidopa

et al. 1990

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Section: Discussionmentioning

confidence: 60%

Palatal myoclonus: Treatment with 5‐hydroxytryptophan and carbidopa

et al. 1990

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“…Its tendon joins the palatal aponeurosis within the soft palate [4]. There is some debate as to whether the clicking noise is produced by the walls of the Eustachian tube snapping together [5], or whether separation of the tubal walls with the breaking of surface tension produces it [6]. Sonotubometry and electromyography have failed to confirm either of these possibilities [7].…”

Section: Discussionmentioning

confidence: 99%

Botulinum toxin is effective and safe for palatal tremor

2006

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Palatal tremor (formerly palatal myoclonus) is an extremely rare, but potentially treatable cause, of objective tinnitus. The tinnitus is thought to be secondary to rhythmic involuntary movements of the soft palate. Its aetiology is variable and it remains difficult to treat. Many different medical and surgical remedies have been tried but none have demonstrated reproducible success. Botulinum toxin has been used in sporadic cases and seems to produce good results. Ten patients with palatal tremor have presented to this department over the last three years. After discussion with the patients with regard to the management of this condition and possible complications, five opted for botulinum toxin therapy and five declined further intervention. Clinical diagnosis was made on the confirmation of soft palate movements synchronous with an audible clicking noise. Five patients underwent botulinum toxin injection into the insertion of the levator and tensor veli palatini muscles. Of the five that were treated with toxin, four showed complete resolution of symptoms after a course of treatment. Only one patient reported transient side effects. This would suggest that botulinum toxin is a safe and effective first line treatment for palatal tremor.

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“…3 It is thought that the noise is produced by the snapping open of the eustachian tube, or secondary to peritubular muscles, causing a break in surface tension as the walls of the eustachian tube pull open. 8 A number of treatments, both medical and surgical, have been advocated for middle-ear myoclonus. Muscle relaxants, benzodiazepines and anticonvulsants have been used with differing degrees of success.…”

Section: Discussionmentioning

confidence: 99%

Bilateral objective tinnitus secondary to congenital middle-ear myoclonus

et al. 2005

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Subjective tinnitus (heard only by the patient) is a common otological complaint. Objective tinnitus (heard by the examiner as well as the patient) is extremely rare. There are only a few cases of objective tinnitus, secondary to middle-ear myoclonus, described in the literature. We present the case of a child with bilateral, congenital, objective tinnitus, secondary to middle-ear myoclonus, with otherwise normal hearing thresholds (250 Hz-8 kHz), and with no evidence of intra-cerebral or systemic disorders. No similar case has been reported in the world literature.

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Palatal myoclonus: A report of two cases

Cited by 47 publications

References 7 publications

Palatal myoclonus: Treatment with 5‐hydroxytryptophan and carbidopa

Palatal myoclonus: Treatment with 5‐hydroxytryptophan and carbidopa

Botulinum toxin is effective and safe for palatal tremor

Bilateral objective tinnitus secondary to congenital middle-ear myoclonus

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