Motor–phonic tic mimicking essential palatal myoclonus

Abstract

CONCLUSIONS DISCUSSION Essential palatal myoclonus (EPM), also referred to as essential palatal tremor, is an uncommon, idiopathic disorder characterized by rhythmic, continuous, bilateral and symmetric movement of the soft palate. Instead of an oscillatory movement typically encountered in tremor, EPM is caused by contractions of the tensor veli palatini muscle, which opens the Eustachian tube and produces a clicking noise. Tics may have a clonic phenotype, but are distinguished from myoclonus by their suppressibility, presence of a premonitory sensation which is relieved by the execution of the tic, and co-morbid neurobehavioral manifestations, such as obsessive compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD).