Abstract
Essential palatal tremor (EPT) is an uncommon disorder, distinct from symptomatic palatal tremor (SPT), but characterized by superficially similar rhythmic movements of the soft palate. While the pathophysiology of SPT has been relatively well defined, this is not the case in EPT. Based on an analysis of 103 published cases, we reviewed EPT in the context of other movement disorders with similar features and outline possible pathophysiological mechanisms. Phenomenologically it remains best classified as a tremor. Four major causes, including a central generator, peripheral/mechanical, voluntary/special skill and psychogenic, appear to account for the majority of cases of EPT, although there is considerable overlap in the pathogenic mechanisms underlying these categories. Among the cases reviewed, a large proportion fit into the latter two categories, although there are others where multiple mechanisms are likely at play. Based on our reappraisal, we suggest a change in designation to 'isolated palatal tremor', with primary and secondary subtypes. This retains the distinction from SPT and emphasizes the non-uniform, heterogeneous nature of the disorder.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 832-840 |
| Number of pages | 9 |
| Journal | Brain |
| Volume | 129 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 2006 |
Funding
The authors would like to thank Susan Winkler, BS for assistance in gathering the old literature and Sylwia Dankert for assistance in preparing the manuscript. C.Z. is an AAN Foundation Clinical Research Fellow. C.K. has been a Heisenberg Fellow of the Deutsche Forschungsgemeinschaft and is supported by a Lichtenberg grant from the Volkswagen Foundation.
Keywords
- Aetiology
- Essential palatal tremor
- Nosology
- Symptomatic palatal tremor
ASJC Scopus subject areas
- Clinical Neurology