Palatal tremor after lithium and carbamazepine use: a case report

Mahasuar, Rajnarayan; Kuruvilla, Anju; Jacob, K. S.

doi:10.1186/1752-1947-4-176

Cited by 7 publications

(5 citation statements)

References 11 publications

(14 reference statements)

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“…In a study by Mahasuar et al .,[ 12 ] on possible drug induced palatal tremors, clonazepam was used in the dose of 0.5 mg/day. However the withdrawal of offending drug (lithium) and the introduction of clonazepam occurred simultaneously and thus it cannot be assumed that the reduction in symptoms was solely due to clonazepam.…”

Section: Discussionmentioning

confidence: 99%

Clonazepam in the treatment of essential palatal tremors

et al. 2012

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Essential Palatal tremor (EPT) is a rare disorder presenting as unilateral or bilateral rhythmic involuntary movements of the soft palate. There is mention of the utility of benzodiazepines like clonazepam probably because of their gamma amino butyric acid (GABA) agonistic property. But no reports are available for the same. Here we report a 30-year old married female patient who presented with the complaints of pain in the lower part of face, behind the ears, back side of neck and clicking sound in her. General physical examination (GPE) revealed symmetrical rhythmic flapping movements of the soft palate and the uvula. Central nervous system (CNS) examination did not reveal any focal deficits and Magnetic resonance imaging (MRI) of the brain was normal. She was diagnosed as having EPT and treated successfully with clonazepam.

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Section: Discussionmentioning

confidence: 99%

Clonazepam in the treatment of essential palatal tremors

et al. 2012

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“…• Traumatic brain injury [49] • Amyotrophic Lateral Sclerosis [50] • Drugs (Ciprofloxacin/Lithium/Carbamazepine) [51,52] • Epilepsy [53] • Hashimoto encephalopathy [54,55] • Anti -GAD antibodies mediated encephalitis [56] Progressive Ataxia and Palatal Tremor (PAPT) I) Sporadic:…”

Section: Ii) Symptomatic Palatal Tremor (Table 2)mentioning

confidence: 99%

Palatal Tremor – Pathophysiology, Clinical Features, Investigations, Management and Future Challenges

Bhattacharjee

2020

Tremor and Other Hyperkinetic Movements

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Background: Palatal tremor is involuntary, rhythmic and oscillatory movement of the soft palate. Palatal tremor can be classified into three subtypes; essential, symptomatic and palatal tremor associated with progressive ataxia. Methods: A thorough Pubmed search was conducted to look for the original articles, reviews, letters to editor, case reports, and teaching neuroimages, with the keywords "essential", "symptomatic palatal tremor", "myoclonus", "ataxia", "hypertrophic", "olivary" and "degeneration". Results: Essential palatal tremor is due to contraction of the tensor veli palatini muscle, supplied by the 5 th cranial nerve. Symptomatic palatal tremor occurs due to the contraction of the levator veli palatini muscle, supplied by the 9 th and 10 th cranial nerves. Essential palatal tremor is idiopathic, while symptomatic palatal tremor occurs due to infarction, bleed or tumor within the Guillain-Mollaret triangle. Progressive ataxia and palatal tremor can be familial or idiopathic. Symptomatic palatal tremor and sporadic progressive ataxia with palatal tremor show signal changes in inferior olive of medulla in magnetic resonance imaging. The treatment options available for essential palatal tremor are clonazepam, lamotrigine, sodium valproate, flunarizine and botulinum toxin. The treatment of symptomatic palatal tremor involves the treatment of the underlying cause. Discussion: Further studies are required to understand the cause and pathophysiology of Essential palatal tremor and progressive ataxia and palatal tremor. Similarly, the link between tauopathy and palatal tremor associated progressive ataxia needs to be explored further. Oscillopsia and progressive ataxia are more debilitating than palatal tremor and needs new treatment approaches.

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“…Ardından sinir sistemi ile ilgili belirtiler ortaya çıkar. SILENT gelişimini belirleyen etmen; akut lityum zehirlenmesi sırasında yüksek serum lityum düzeyinin hızlı düzeltilmesi, yüksek ateş, eş zamanlı kullanılan diğer ilaçlar (antipsiko-tikler, trisiklik antidepresanlar ve antikonvülzanlar), hiponatreminin hızlı düzeltilmesi, eş zamanlı hastalıkların (enfeksiyon, dehidratasyon, hipertansiyon, kronik böbrek yetmezliği, kalp yetmezliği, epilepsi, akut gastroenterit, Alzheimer ve Gullian Barre) olmasıdır (16,17). SILENT şizoaffektif bozuklukta ve belirgin psikotik bulguları ve/veya anksiyetesi olan hastalarda iki uçlu bozukluğu olan hastalara göre daha sık görülür.…”

Section: Silent Sendromuunclassified

Neurological side effects of lithium

Özdin¹,

Sarısoy²

2013

JMOOD

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Lityumun nörolojik yan etkileri Lityum 1940'lı yılların sonuna doğru Avustralya'lı bilim adamı John Cade'in çalışmaları sonucunda iki uçlu mizaç bozukluğunda yaygın olarak kullanılmaya başlanmıştır. Terapötik aralığının dar olması kullanımını kısıtlasa da iki uçlu bozukluk tedavisinde en önemli ilaçlardan biridir. Terapötik aralığının dar olmasından dolayı lityum zehirlenmesine sık rastlanır. Lityum kullanımı ile midebarsak, kalp-damar, dermatolojik, endokrinolojik ve sinir sistemlerini ilgilendiren birçok yan etki gelişebilmektedir. Gerek zehirlenmede gerekse normal serum düzeylerinde sinir sistemi ile ilgili yan etkilere sıklıkla rastlanmaktadır. Sinir sistemi ile ilgili yan etkiler lityum tedavisinin nadir olmayan, ancak en az tanınan yan etkilerindendir. Merkezi sinir sistemi ile ilgili yan etkiler hastanın ilaca uyumu konusunda önemli bir sorun teşkil etmektedir. Bu derlemenin amacı lityum kullanımı ya da zehirlenmesine bağlı ortaya çıkan sık ve az görülen nörolojik yan etkilerin gözden geçirilmesidir.

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Palatal tremor after lithium and carbamazepine use: a case report

Cited by 7 publications

References 11 publications

Clonazepam in the treatment of essential palatal tremors

Clonazepam in the treatment of essential palatal tremors

Palatal Tremor – Pathophysiology, Clinical Features, Investigations, Management and Future Challenges

Neurological side effects of lithium

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