Journal Article

The ‘essentials’ of essential palatal tremor: a reappraisal of the nosology

C. Zadikoff, A. E. Lang and C. Klein

in Brain

Published on behalf of The Guarantors of Brain

Volume 129, issue 4, pages 832-840
Published in print April 2006 | ISSN: 0006-8950
Published online November 2005 | e-ISSN: 1460-2156 | DOI:
The ‘essentials’ of essential palatal tremor: a reappraisal of the nosology

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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.

Keywords: essential palatal tremor; nosology; symptomatic palatal tremor; aetiology; EPT = essential palatal tremor; LVP = levator veli palatini; SPT= symptomatic palatal tremor; PT = palatal tremor; TVP = tensor veli palatini

Journal Article.  6722 words. 

Subjects: Neurology ; Neuroscience

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