We report clinical and
neurophysiological findings in two
patients with palatal tremor (PT).
In both patients a prompt and persistent
suppression of palatal
movements and clicking sounds is
caused by slight passive or active
mouth opening. One patient has a
typical essential palatal tremor
(EPT) according to current classification
criteria. The other one has a
PT characterized by involuntary
activation of levator veli palatini
and genioglossus muscles. Objective
clicking sounds were observed
late during the course of the disease.
A symptomatic aetiology was
excluded, suggesting a diagnosis of
atypical EPT.
Our observations further confirm
that unusual features of some
cases may not fit current PT classification
criteria. These two cases
have several features that distinguish
them from voluntary PT and
from psychogenic PT. We emphasize
that clear cut modulating phenomena
may be relevant features in
both typical and atypical involuntary
EPT. We finally focus on the
significance of jaw posture in determining
PT suppression in our
patients.
Key words palatal tremor - clinical manoeuvres - sensory input
modulation - jaw posture