Palatal tremor with audible click

Palatal tremor and myoclonus are the terms used for rhythmic bilateral movements of palate due to excitability of brainstem. It encompasses two types of essential palatal tremor (EPT) and symptomatic palatal tremor (SPT).

The main feature of EPT is an audible click in the ear due to contraction of tensor veli palatini muscle. It usually disappears during sleep.1 In contrast to EPT, SPT lacks audible click and often persists in sleep. Contraction of levator veli palatini muscle is responsible for this type of palatal tremor. Brain MRI is normal in EPT and shows olivary hypertrophy or lesion in dentate–olivary pathway in SPT.23

Here, we present a 52-year-old female who suffered from rhythmic movements of the palate for 10 years that was accompanied by audible click (see online ). The clicks would disappear during sleep. The brain MRI was normal. Her symptoms completely improved...

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