Palatal tremor as a manifestation of posterior circulation haemorrhagic stroke

Description

Palatal tremor (previously called palatal myoclonus) is an extremely rare movement disorder characterised by involuntary, rhythmic contractions of the palatal muscles. Due to its rarity, this cryptic neurological finding is practically challenging to discover, and often missed by clinicians unless specifically looked for during physical examination.

Palatal tremor was first described by Politzer in 1862. Its prevalence data are lacking in the literature, with only a few hundred cases reported. The most notable pathological change is hypertrophic degeneration of the inferior olivary nuclei, which are presumed to be the pacemaker of symptomatic palatal tremor. The rhythmic inferior olivary activity is transmitted to the brainstem reticular centres controlling bulbar and limb functions.1

Two forms of palatal tremor have been described: essential and symptomatic. The aetiology of essential palatal tremor remains unclear. It can be idiopathic or psychogenic, but without any focal lesions on brain imaging. In essential palatal...

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