Abstract
Introduction: Palatal myoclonus (PM) is a rare cause of objective tinnitus, secondary to rhythmic voluntary or involuntary movements of the soft palate. Cases: We report two cases; nineteen-year-old girl and 18-year-old boy who presented our clinic with bilateral tinnitus and diagnosed as PM. Clinical diagnosis was made on the confirmation of soft palate movements synchronus with an audible clicking noise. Neurologic examination, cranial MR and MR angiography were normal in both patients. Since the systemic drug therapy was unsuccessful, 15 U botulinum neurotoxin A (botox-A) (BOTOX®, Allergan, Inc., Irvine, CA, USA) has injected into both sides of the soft palate in patients. Tinnitus has disappeared immediately after the injections. There were not any complaint after twenty months follow-up. Conclusion: In the light of literature, our findings show that botox-A injection is an effective treatment in PM. Key words: Myoclonus, Botulinum Neurotoxin A, Objective Tinnitus
Keywords
References
- Deuschl G, Mischke G, Schenck E, Schulte-Monting J, Lucking CH. Symptomatic and essential rhytmic palatal myoclonus. Brain 1990;113:1645-72.
- Deuschl G, Lohle E, Heinen F, Lucking C. Ear click in palatal tremor: Its origin and treatment with botulinum toxin. Neurology 1991;41:1677-9.
- Yetiser S, Kazkayası M, Civitci D. Acoustic impedance study of peritubal myoclonus. Acta Otolaryngol 2002;122:504-9.
- Seidman MD, Arenberg JG, Shirwany NA. Palatal myoclonus as a cause of objective tinnitus: A report of six cases and review of the literature. ENT J 1999;78:292-5.
- Jero J, Salmi T. Palatal myoclonus and clicking tinnitus in a 12- year-old girl: case report. Acta Otolaryngol 2000; Suppl 543:61-2.
- Pulec JL, Simonton KM. Palatal myoclonus: A report of two cases. Laryngoscope 1961;71:668-71.
- Slack RWT, Soucek SO, Wong K. Sonotubometry in the investigatin of onjective tinnitus and palatal myoclonus: a demonstration of eustachian tube opening. J Laryngol Otol 1986;100:529-31.
- Bryce GE, Morrison MD. Botulinum toxin treatment of essential palatal myoclonus tinnitus. J Otolaryngol 1998;27(4):213-6.
- Penney SE, Bruce IA, Saeed SR. Botulinum toxin is effective and safe for palatal tremor: a report of five cases and a review of the literature. J Neurol 2006;253:857-60.
- Fritsch MH, Wynne MK, Matt BH, Smith WL, Smith CM. Objective tinnitus in children. Otol Neurotol 2001;22:644-9.
- Yajin K, Miyawaki S, Sugata Y, Suzuki M, Kurokawa M,
- Takebayashi S. Objective tinnitus caused by myoclonus of the musculus tensor veli palitini. HNO 1985;33:45-9.
Abstract
Giriş: Palatal miyoklonus (PM) nadir görülen, palatal kasların istemli veya istemsiz ritmik kasılmaları ile karakterize bir objektif tinnitus nedenidir. Olgular: Bu çalışmada kliniğimizde tedavisi yapılan iki olgu sunuldu. Ondokuz yaşında kadın ve 18 yaşında erkek hasta, her iki kulağında çınlama yakınması ile başvurdu. Yumuşak damakta gözle görülen ritmik kasılmalar ve hasta ve doktor tarafından işitilen çıtırtı sesi ile PM tanısı konuldu. Nörolojik muayene, kraniyal MR ve MR anjiyografide anormallik saptanmadı. Medikal tedaviden fayda görmemeleri nedeniyle her iki hastanın yumuşak damağına 15 U sağa 15 U sola olacak şekilde botulinum nörotoksin A (botoks-A) (BOTOX®, Allergan, Inc., Irvine, CA, USA) enjekte edildi. Enjeksiyonların ardından tinnitus hemen kayboldu ve yirmi aylık izlemde tekrar oluşmadı. Sonuç: Bu bulgular, literatürdeki diğer olgu sonuçları ile birlikte değerlendirildiğinde, botox-A uygulamasının, PM tedavisinde etkili bir yöntem olduğu görülmektedir. Anahtar Sözcükler: Palatal Miyoklonus, Botulinum Nörotoksin A, Objektif Tinnitus
Keywords
References
- Deuschl G, Mischke G, Schenck E, Schulte-Monting J, Lucking CH. Symptomatic and essential rhytmic palatal myoclonus. Brain 1990;113:1645-72.
- Deuschl G, Lohle E, Heinen F, Lucking C. Ear click in palatal tremor: Its origin and treatment with botulinum toxin. Neurology 1991;41:1677-9.
- Yetiser S, Kazkayası M, Civitci D. Acoustic impedance study of peritubal myoclonus. Acta Otolaryngol 2002;122:504-9.
- Seidman MD, Arenberg JG, Shirwany NA. Palatal myoclonus as a cause of objective tinnitus: A report of six cases and review of the literature. ENT J 1999;78:292-5.
- Jero J, Salmi T. Palatal myoclonus and clicking tinnitus in a 12- year-old girl: case report. Acta Otolaryngol 2000; Suppl 543:61-2.
- Pulec JL, Simonton KM. Palatal myoclonus: A report of two cases. Laryngoscope 1961;71:668-71.
- Slack RWT, Soucek SO, Wong K. Sonotubometry in the investigatin of onjective tinnitus and palatal myoclonus: a demonstration of eustachian tube opening. J Laryngol Otol 1986;100:529-31.
- Bryce GE, Morrison MD. Botulinum toxin treatment of essential palatal myoclonus tinnitus. J Otolaryngol 1998;27(4):213-6.
- Penney SE, Bruce IA, Saeed SR. Botulinum toxin is effective and safe for palatal tremor: a report of five cases and a review of the literature. J Neurol 2006;253:857-60.
- Fritsch MH, Wynne MK, Matt BH, Smith WL, Smith CM. Objective tinnitus in children. Otol Neurotol 2001;22:644-9.
- Yajin K, Miyawaki S, Sugata Y, Suzuki M, Kurokawa M,
- Takebayashi S. Objective tinnitus caused by myoclonus of the musculus tensor veli palitini. HNO 1985;33:45-9.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Articles |
| Authors | |
| Publication Date | June 1, 2009 |
| Published in Issue | Year 2009 Volume: 16 Issue: 3 |