Symptomatic Palatal Tremor Associated with Cerebellar Hemorrhage: A Case Report

ABSTRACT

Palatal tremor is a rare disorder characterized by involuntary rhythmic movements of the soft palate. Palatal tremor is devided into symptomatic palatal tremor(SPT) and essential palatal tremor(EPT) on the basis of clinical features. SPT is associated with brain stem or cerebellar disease, whereas the EPT has no known etiology. Reverberant neural activity in the region of the brain stem or cerebellum within the Guillain-Mollaret triangle is believed to underlie SPT. We present a case of SPT associated with cerebellar lesion. Electromyographic recording from the levator veli palatini muscle and voice spectrogram analysis showed abnormal bursting activity time locked to the palatal movements. Botulinum toxin was injected into the levator veli palatini muscle to reduce the voice tremor. The pathology and management of this condition is briefly discussed.