The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Hiroshi Tsukagoshi - One of the best experts on this subject based on the ideXlab platform.
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Idiopathic Palatal Myoclonus
2009Co-Authors: T. Yokota, Fumiko Hirashima, Y. Ito, H. Tanabe, Tetsuo Furukawa, Hiroshi TsukagoshiAbstract:Two cases with idiopathic Palatal Myoclonus without other neurological deficits were described. They did not have any other neurological deficits other than Myoclonus of branchial muscles. In these cases, the Myoclonus disappeared during natural or induced sleep. In Case 1, the Myoclonus ceased transiently when the patient was calculating or receiving an injection. In Case 2, the Myoclonus disappeared with intravenous injection of saline as a placebo. Detailed examinations, including brain CT, MRI and multiple evoked potentials, showed normal results. The Myoclonus in Case 2 disappeared after we had explained that her disease was benign. Since the clinical features and laboratory data in idiopathic Palatal Myoclonus are quite different from those in Palatal Myoclonus with other neurological deficits, idiopathic Palatal Myoclonus is considered to be a separate syndrome. Invasive examinations or excessive medications should be avoided because of its benign prognosis.
Andrew Blitzer - One of the best experts on this subject based on the ideXlab platform.
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Palatal Myoclonus algorithm for management with botulinum toxin based on clinical disease characteristics
2014Co-Authors: Catherine F Sinclair, Lowell E Gurey, Andrew BlitzerAbstract:Objectives/Hypothesis To review the clinical characteristics and management of patients with Palatal Myoclonus and devise an algorithm for treatment with botulinum toxin based on presenting symptoms, clinical examination findings, and involved muscle groups. Study Design Retrospective chart review at two clinical research centers. Methods Between 1985 and 2011, 15 patients with a diagnosis of essential Palatal Myoclonus were assessed. Data were collected on patient demographics, disease characteristics, and treatment outcomes. Results Patients were more commonly female (60.0% vs. 40.0%) with average age at onset of 35.6 years. In 40.0% of patients, the Myoclonus began after a viral upper respiratory tract infection. Two-thirds of patients had been previously treated unsuccessfully with oral medications. Predominant presenting symptoms included clicking tinnitus (46.7%), nonaudible awareness of Palatal movements ± rhinolalia (20.0%), or both (33.3%). Clinical examination revealed co-incident involvement of pharyngeal musculature in 53.3%. Palatal site for initial botulinum toxin injection depended on the predominant presenting symptom: for tinnitus, 2.5 U were injected transorally into the tensor veli palatini muscle at the level of the pterygoid hamulus/lateral soft palate; for Palatal movements, the injection was placed medially on either side of the uvula. Dose and location of subsequent injections were tailored depending on response to the toxin and location of subsequent observed maximal muscular contractions. Conclusions Palatal Myoclonus can present with tinnitus or patient-perceived Palatal movements. Management with botulinum toxin can be tailored to address the muscles contributing to the predominant presenting symptoms. Level of Evidence 4 Laryngoscope, 124:1164–1169, 2014
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Palatal Myoclonus treatment with botulinum toxin
2004Co-Authors: Ajay Chitkara, Anthony Cultrara, Andrew BlitzerAbstract:Abstract Palatal Myoclonus is a rare neurological disorder, which manifests as involuntary Palatal contractions. It may be related to an underlying neurological abnormality or it may be of unknown etiology. The most common symptom is objective clicking tinnitus. Systemic treatment is largely unsuccessful. The use of botulinum toxin type A has been effective in treating the symptom with limited adverse effects.
P Nakstad - One of the best experts on this subject based on the ideXlab platform.
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bulbar Myoclonus without Palatal Myoclonus a hypothesis on pathophysiology
1999Co-Authors: Espen Dietrichs, Mona Skard Heier, Hilde Fayelund, P NakstadAbstract:A 40-year-old woman with myoclonic contractions bilaterally in the infrahvoid neck muscles, especially in the left cricothyroid muscle, was presented and successfully treated with botulinum toxin injections. The patient had a wide, aberrant vessel curving into the left dorsolateral reticular formction of the medulla oblongata. Based on our observations, we propose that symptomatic bulbar and Palatal Myoclonus is caused by pathology in the dorsolateral reticular formation, and not by inferior olivary dysfunction as is currently thought.
T. Yokota - One of the best experts on this subject based on the ideXlab platform.
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Idiopathic Palatal Myoclonus
2009Co-Authors: T. Yokota, Fumiko Hirashima, Y. Ito, H. Tanabe, Tetsuo Furukawa, Hiroshi TsukagoshiAbstract:Two cases with idiopathic Palatal Myoclonus without other neurological deficits were described. They did not have any other neurological deficits other than Myoclonus of branchial muscles. In these cases, the Myoclonus disappeared during natural or induced sleep. In Case 1, the Myoclonus ceased transiently when the patient was calculating or receiving an injection. In Case 2, the Myoclonus disappeared with intravenous injection of saline as a placebo. Detailed examinations, including brain CT, MRI and multiple evoked potentials, showed normal results. The Myoclonus in Case 2 disappeared after we had explained that her disease was benign. Since the clinical features and laboratory data in idiopathic Palatal Myoclonus are quite different from those in Palatal Myoclonus with other neurological deficits, idiopathic Palatal Myoclonus is considered to be a separate syndrome. Invasive examinations or excessive medications should be avoided because of its benign prognosis.
Fumiko Hirashima - One of the best experts on this subject based on the ideXlab platform.
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Idiopathic Palatal Myoclonus
2009Co-Authors: T. Yokota, Fumiko Hirashima, Y. Ito, H. Tanabe, Tetsuo Furukawa, Hiroshi TsukagoshiAbstract:Two cases with idiopathic Palatal Myoclonus without other neurological deficits were described. They did not have any other neurological deficits other than Myoclonus of branchial muscles. In these cases, the Myoclonus disappeared during natural or induced sleep. In Case 1, the Myoclonus ceased transiently when the patient was calculating or receiving an injection. In Case 2, the Myoclonus disappeared with intravenous injection of saline as a placebo. Detailed examinations, including brain CT, MRI and multiple evoked potentials, showed normal results. The Myoclonus in Case 2 disappeared after we had explained that her disease was benign. Since the clinical features and laboratory data in idiopathic Palatal Myoclonus are quite different from those in Palatal Myoclonus with other neurological deficits, idiopathic Palatal Myoclonus is considered to be a separate syndrome. Invasive examinations or excessive medications should be avoided because of its benign prognosis.