Schwartz Richard H, Bahadori Robert S, Myseros John S
Department of Pediatrics, Section of Pediatric Otolaryngology, Inova Fairfax Hospital for Children, Falls Church, VA, USA.
Pediatr Emerg Care. 2012 Feb;28(2):158-9. doi: 10.1097/PEC.0b013e3182443000.
An 8-year-old boy was seen by his primary care pediatrician with a chief complaint of "intermittent rapid vibrations of the epiglottis" that began several weeks prior. Intraoral examination revealed rapid, symmetrical bilateral contractions of the soft palate muscles (velum), accompanied by clicking sounds audible to physician (objective tinnitus) and patient. The patient was able to volitionally control the initiation and cessation of the palatal movements. The child's mother stated that there had been no clicking noises heard while the boy was sound asleep. Palatal "clonus" was tentatively diagnosed as the cause of the problem. A normal magnetic resonance imaging study with contrast enhancement confirmed that there was no anatomical basis for the localized movement disorder.Palatal myoclonus is an uncommon localized intraoral movement disorder. There are 2 distinct types, and our patient was diagnosed with the essential palatal myoclonus type. This type is characteristically associated with clicking tinnitus, heard by the affected person as well as those in close proximity. The clicking noise is not continuous, ceases during sleep, and is not lifelong.
一名8岁男孩因“会厌间歇性快速振动”的主诉，由其初级保健儿科医生接诊，该症状始于数周前。口腔检查发现软腭肌肉（腭帆）快速、对称的双侧收缩，伴有医生（客观性耳鸣）和患者都能听到的咔哒声。患者能够自主控制腭部运动的开始和停止。患儿母亲称，男孩熟睡时没有听到咔哒声。腭部“阵挛”被初步诊断为问题的原因。一项正常的磁共振成像检查及对比增强显示，局部运动障碍没有解剖学基础。腭肌阵挛是一种罕见的局部口腔内运动障碍。有两种不同类型，我们的患者被诊断为特发性腭肌阵挛类型。这种类型的特征是伴有咔哒样耳鸣，患者本人以及附近的人都能听到。咔哒声不持续，睡眠时停止，并非终生存在。
