Essential Palatal Myoclonus treated with Botulinum Toxin A (Dysport)

J Korean Assoc EMG Electrodiagn Med 2005;7(1):50-53.
Published online May 10, 2005.

Abstract

Palatal myoclonus is an uncommon movement disorder involving soft palate or oropharyngeal muscles innervated by cerebral or spinal nerves. A variety of different etiologies of palatal myoclonus have been described, including cerebrovacular disease, multiple sclerosis, meningoencephalitis, infectious disease, head trauma, neoplasm, Alexander syndrome or other congenital malformation of the brain. It can be idiopathic, but it is extremely rare. Rhythmical and involuntary contractions of soft palate make tinnitus and otalgia, and it can be heard by observer. Pharmacotheraphy for palatal myoclonus include carbamazepine, tryptophan, lamotrigine, but none of these treatments has been consistently effective. We present here a case of essential palatal myoclonus treated with Clostridium botulinum toxin A (Dysport) injection into bilateral tensor veli palatini muscles guided by electromyography and endoscopy. Tinnitus and otalgia were vanished 2 days after injection. Needle electromyography showed decreased MUAPs (motor unit action potentials) as time goes by.

Key Words: Palatal myoclonus, Botulinum toxin, Tinnitus, Otalgia