Palatal tremor (formerly palatal myoclonus) is an extremely rare, but potentially treatable cause, of objective tinnitus. The tinnitus is thought to be secondary to rhythmic involuntary movements of the soft palate. Its aetiology is variable and it remains difficult to treat. Many different medical and surgical remedies have been tried but none have demonstrated reproducible success. Botulinum toxin has been used in sporadic cases and seems to produce good results. Ten patients with palatal tremor have presented to this department over the last three years. After discussion with the patients with regard to the management of this condition and possible complications, five opted for botulinum toxin therapy and five declined further intervention. Clinical diagnosis was made on the confirmation of soft palate movements synchronous with an audible clicking noise. Five patients underwent botulinum toxin injection into the insertion of the levator and tensor veli palatini muscles. Of the five that were treated with toxin, four showed complete resolution of symptoms after a course of treatment. Only one patient reported transient side effects. This would suggest that botulinum toxin is a safe and effective first line treatment for palatal tremor.

译文

腭部震颤 (以前称为腭肌阵挛) 是客观耳鸣的一种极其罕见但可能可治疗的原因。耳鸣被认为是继发于软腭的节律性非自愿运动的继发。它的病因是可变的,仍然很难治疗。已经尝试了许多不同的医学和外科治疗方法,但没有一种方法可以重现成功。肉毒杆菌毒素已用于零星病例,似乎产生良好的效果。在过去三年中,有10名pa震颤患者出现在该部门。在与患者讨论了这种情况的治疗方法和可能的并发症之后,五个人选择了肉毒杆菌毒素治疗,五个人拒绝了进一步的干预。临床诊断是在确认软pa运动与可听见的喀哒声同步进行的。五名患者接受了肉毒杆菌毒素注射到提肌和张肌肌的插入中。在接受毒素治疗的五人中,有四人在一个疗程后症状完全消失。只有一名患者报告了短暂的副作用。这表明肉毒杆菌毒素是治疗pa震颤的安全有效的一线治疗方法。

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