Palatal myoclonus (Palatal tremor)
Symptomatic palatal myoclonus occurs with a lesion involving the Guillain-Mollaret (myoclonic) triangle that connects the inferior olivary, dentate, and red nuclei, interrupting the central tegmental tract. See Palatal myoclonus due to a brainstem stroke(4) Hypertrophy (pseudohypertrophy) of the inferior olive may occur and can sometimes be seen by MRI. Palatal myoclonus is also referred to as palatal tremor or microtremor but whether palatal myoclonus is best characterized as rhythmic myoclonus or a tremor remains unclear.
Video courtesy of Dr. Jason S. Hawley, Walter Reed National Military Medical Center
References
1. Campbell WW. Clinical signs in neurology: a compendium. Philadelphia: Wolters Kluwer Health, 2016. 2. Campbell WW. DeJong's the neurologic examination, 7th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2013. 3. Pearce, JM. Palatal Myoclonus (syn. Palatal Tremor). Eur Neurol. 2008; 60:312-315. 4. Sivakumar S, Rajamani K. Secondary Palatal Myoclonus. N Engl J Med. 2015 Jul 16;373(3):e3