Psychogenic palatal tremor may be underrecognized: reappraisal of a large series of cases

Mov Disord. 2012 Aug;27(9):1164-1168. doi: 10.1002/mds.24948. Epub 2012 Mar 20.

Abstract

Background: Palatal tremor is characterized by rhythmic movements of the soft palate and can be essential or symptomatic. Some patients can have palatal movements as a special skill or due to palatal tics. Psychogenic palatal tremor is recognized but rarely reported in the literature.

Methods: We retrospectively evaluated all patients with palatal tremor seen in our center over a period of 10 years.

Results: Of 17 patients with palatal tremor, we identified 10 patients with isolated palatal tremor. In 70% of those the diagnosis of psychogenic palatal tremor could be made. Of the remainder, 2 had palatal tics and 1 essential palatal tremor.

Conclusions: We suggest that psychogenic palatal tremor may be underrecognized and propose that targeted clinical examination of positive signs for psychogenic movement disorders in these patients is essential. The correct identification of such patients has important clinical and scientific implications.

MeSH terms

  • Adult
  • Age of Onset
  • Anti-Dyskinesia Agents / therapeutic use
  • Botulinum Toxins, Type A / therapeutic use
  • Cognitive Behavioral Therapy
  • Electromyography
  • Female
  • Glial Fibrillary Acidic Protein / genetics
  • Humans
  • Male
  • Mental Disorders / complications
  • Palatal Muscles / physiopathology*
  • Psychophysiologic Disorders / diagnosis
  • Psychophysiologic Disorders / genetics
  • Psychophysiologic Disorders / physiopathology*
  • Tics / etiology
  • Tremor / diagnosis
  • Tremor / genetics
  • Tremor / physiopathology*

Substances

  • Anti-Dyskinesia Agents
  • Glial Fibrillary Acidic Protein
  • Botulinum Toxins, Type A