Morini Alberto, Boninsegna Claudio, Nostro Mariaclara, Simonetti Stefano, Orrico Daniele, Moretto Giuseppe, Tinazzi Michele
Unità Operativa di Neurologia, Ospedale Santa Chiara, Piazzale Medaglie d'oro n degree 1, 38100 Trento, Italy.
J Neurol. 2005 Nov;252(11):1335-40. doi: 10.1007/s00415-005-0861-5. Epub 2005 Jul 20.
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.
我们报告了两名腭震颤（PT）患者的临床和神经生理学发现。在这两名患者中，轻微的被动或主动张口都会迅速且持续地抑制腭部运动和咔嗒声。根据目前的分类标准，一名患者患有典型的原发性腭震颤（EPT）。另一名患者的PT表现为腭帆提肌和颏舌肌的非自主激活。在疾病过程后期观察到了客观的咔嗒声。排除了症状性病因，提示诊断为非典型EPT。我们的观察结果进一步证实，某些病例的不寻常特征可能不符合当前的PT分类标准。这两个病例有几个特征将它们与自愿性PT和精神性PT区分开来。我们强调，明确的调节现象可能是典型和非典型非自愿性EPT的相关特征。我们最后关注下颌姿势在确定我们患者的PT抑制中的重要性。
