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Symptomatic palatal tremor is not limited to the activity of guillain-mollaret triangle: A functional magnetic resonance imaging case study

Year 2012, Volume: 34 Issue: 3, 347 - 351, 16.02.2012

Abstract

A 57-year-old man was admitted to our clinic because of speech and swallowing disorder for six months. Palatal tremor and left upper extremity myorhythmia appeared on examination. Magnetic resonance imaging showed hypertrophic olivary degeneration, dentate pathology, Wallerian degeneration, and left parietal cystic encephalomalacia. Functional magnetic resonance imaging study of the brain showed prominent activation on the bilateral globus pallidus and thalamus. We suggest that involuntary movements were introduced by the nuclei of the basal ganglia as a result of olivary dysinhibition.

 

Özet

Elliyedi yaşında erkek hasta altı aydır olan konuşma ve yutma zorluğu nedeni ile kliniğimize başvurdu. Muayenede ritmik palatal tremor ve solda üst ekstremite kaslarında miyoritmi görüldü. Beyin manyetik rezonans görüntüleme çalışmasında oliver çekirdekte hipertrofik dejenerasyon, dentat çekirdek patolojisi, Wallerian dejenerasyon ve sol parietal hemisferde kistik ensefalomalazik alan görüldü. Fonksiyonel manyetik rezonans görüntülemede her iki globus pallidus ve talamusta belirgin aktivasyon tespit edildi. Bu olgu çalışmasından elde edilen sonuçlar; palatal tremorda görülen istemsiz hareketlerin olivar çekirdeğin disinhibisyonu sonucu bazal çekirdekler tarafından oluşturulduğunu düşündürmüştür.

Anahtar sözcükler: Palatal tremor, etyoloji, mekanizma, fonksiyonel görüntüleme

References

  • Goyal M, Versnick E, Tuite P, Cyr JS, Kucharczyk W, Montanera W, Willinsky R, Mikulis D. Hypertrophic olivary degeneration: metaanalysis of the temporal evolution of MR findings. Am J Neuroradiol 2000; 21: 1073-7.
  • Choh NA, Choh SA, Jehangir M. Hypertrophic olivary degeneration: the forgotten triangle of Guillain and Mollaret. Neurol India 2009; 57: 507-9.
  • Hommet CD, De Toffol B, Cottier JP, Autret A. Bilateral olivary hypertrophy and palatal myoclonus. Surg Neurol 1998; 49: 215-6.
  • Haller S, Winkler DT, Gobbi C, Lyrer P, Wetzel SG, Steck AJ. Prominent activation of the putamen during essential palatal tremor: A functional MR imaging case study. Am J Neuroradiol 2006; 27: 1272-4.
  • Okamoto Y, Mitsuyama H, Jonosono M, Hirata K, Arimura K, Osame M, Nakagawa M. Autosomal dominant palatal myoclonus and spinal cord atrophy. J Neurol Sci 2002; 195: 71-6.
  • Suyama N, Kobayashi S, Isino H, Iijima M, Imaoka K. Progressive supranuclear palsy with palatal myoclonus. Acta Neuropathol 1997; 94: 290-3.
  • Birbamer G, Gerstenbrand F, Aichner F, Buchberger W, Chemelli A, Langmayr J, Lo Presti R, Pollicino P, Bramanti P. MR-imaging of post-traumatic olivary hypertrophy. Funct Neurol 1994; 9: 183-7.
  • Bansal B, Singh P, Shukla R. Palatal myoclonus following head injury: letter to the editor. Neurol India 2002; 50: 222-3.
  • Hirono N, Kameyama M, Kobayashi Y, Udaka F, Mezaki T, Abe K, Nishitani N. MR demonstration of a unilateral olivary hypertrophy caused by pontine tegmental hematoma. Neuroradiology 1990; 32: 340-2.
  • Salamon-Murayama N, Russell EJ, Rabin BM. Diagnosis please. Case 17: hypertrophic olivary degeneration secondary to pontine hemorrhage. Radiology 1999; 213: 814-7.
  • Deuschl G, Wilms H. Clinical spectrum and physiology of palatal tremor. Mov Disord 2002; 17 Suppl 2: S63-6.
  • Alstadhaug KB. Oculopalatal and cerebellar limb tremor due to hypertrophic olivary degeneration. Eur J Neurol 2007; 14: e6-7.
  • Tsui EY, Cheung YK, Mok CK, Yuen MK, Chan JH. Hypertrophic olivary degeneration following surgical excision of brainstem cavernous hemangioma: a case report. Clin Imaging 1999; 23: 215-7.
  • Kim SJ, Lee JH, Suh DC. Cerebellar MR changes in patients with olivary hypertrophic degeneration. Am J Neuroradiol 1994; 15: 1715-9.
  • Rabin BM, Hebel DJ, Salamon-Murayama N, Russell EJ. Distal neuronal degeneration caused by intracranial lesions. AJR Am J Roentgenol 1998; 171: 95-102.
  • Nishie M, Yoshida Y, Hirata Y, Matsunaga M. Generation of symptomatic palatal tremor is not correlated with inferior olivary hypertrophy. Brain 2002; 125: 1348-57.
  • Nitschke MF, Krüger G, Bruhn H, Klein C, Gehrking E, Wessel K, Frahm J, Vieregge P. Voluntary palatal tremor is associated with hyperactivation of the inferior olive: a functional magnetic resonance imaging study. Mov Disord 2001; 16: 1193-5.

Semptomatik palatal tremor guillain-mollaret üçgeninin aktivitesi ile sınırlı değildir: Bir fonksiyonel manyetik rezonans görüntüleme olgu çalışması Hatice Balaban*, Özlem Kayım Yıldız, İbrahim Öztoprak, Ertuğrul Bolayır, Suat Topaktaş

Year 2012, Volume: 34 Issue: 3, 347 - 351, 16.02.2012

Abstract

Elliyedi yaşında erkek hasta altı aydır olan konuşma ve yutma zorluğu nedeni ile kliniğimize başvurdu. Muayenede ritmik palatal tremor ve solda üst ekstremite kaslarında miyoritmi görüldü. Beyin manyetik rezonans görüntüleme çalışmasında oliver çekirdekte hipertrofik dejenerasyon, dentat çekirdek patolojisi, Wallerian dejenerasyon ve sol parietal hemisferde kistik ensefalomalazik alan görüldü. Fonksiyonel manyetik rezonans görüntülemede her iki globus pallidus ve talamusta belirgin aktivasyon tespit edildi. Bu olgu çalışmasından elde edilen sonuçlar; palatal tremorda görülen istemsiz hareketlerin olivar çekirdeğin disinhibisyonu sonucu bazal çekirdekler tarafından oluşturulduğunu düşündürmüştür

References

  • Goyal M, Versnick E, Tuite P, Cyr JS, Kucharczyk W, Montanera W, Willinsky R, Mikulis D. Hypertrophic olivary degeneration: metaanalysis of the temporal evolution of MR findings. Am J Neuroradiol 2000; 21: 1073-7.
  • Choh NA, Choh SA, Jehangir M. Hypertrophic olivary degeneration: the forgotten triangle of Guillain and Mollaret. Neurol India 2009; 57: 507-9.
  • Hommet CD, De Toffol B, Cottier JP, Autret A. Bilateral olivary hypertrophy and palatal myoclonus. Surg Neurol 1998; 49: 215-6.
  • Haller S, Winkler DT, Gobbi C, Lyrer P, Wetzel SG, Steck AJ. Prominent activation of the putamen during essential palatal tremor: A functional MR imaging case study. Am J Neuroradiol 2006; 27: 1272-4.
  • Okamoto Y, Mitsuyama H, Jonosono M, Hirata K, Arimura K, Osame M, Nakagawa M. Autosomal dominant palatal myoclonus and spinal cord atrophy. J Neurol Sci 2002; 195: 71-6.
  • Suyama N, Kobayashi S, Isino H, Iijima M, Imaoka K. Progressive supranuclear palsy with palatal myoclonus. Acta Neuropathol 1997; 94: 290-3.
  • Birbamer G, Gerstenbrand F, Aichner F, Buchberger W, Chemelli A, Langmayr J, Lo Presti R, Pollicino P, Bramanti P. MR-imaging of post-traumatic olivary hypertrophy. Funct Neurol 1994; 9: 183-7.
  • Bansal B, Singh P, Shukla R. Palatal myoclonus following head injury: letter to the editor. Neurol India 2002; 50: 222-3.
  • Hirono N, Kameyama M, Kobayashi Y, Udaka F, Mezaki T, Abe K, Nishitani N. MR demonstration of a unilateral olivary hypertrophy caused by pontine tegmental hematoma. Neuroradiology 1990; 32: 340-2.
  • Salamon-Murayama N, Russell EJ, Rabin BM. Diagnosis please. Case 17: hypertrophic olivary degeneration secondary to pontine hemorrhage. Radiology 1999; 213: 814-7.
  • Deuschl G, Wilms H. Clinical spectrum and physiology of palatal tremor. Mov Disord 2002; 17 Suppl 2: S63-6.
  • Alstadhaug KB. Oculopalatal and cerebellar limb tremor due to hypertrophic olivary degeneration. Eur J Neurol 2007; 14: e6-7.
  • Tsui EY, Cheung YK, Mok CK, Yuen MK, Chan JH. Hypertrophic olivary degeneration following surgical excision of brainstem cavernous hemangioma: a case report. Clin Imaging 1999; 23: 215-7.
  • Kim SJ, Lee JH, Suh DC. Cerebellar MR changes in patients with olivary hypertrophic degeneration. Am J Neuroradiol 1994; 15: 1715-9.
  • Rabin BM, Hebel DJ, Salamon-Murayama N, Russell EJ. Distal neuronal degeneration caused by intracranial lesions. AJR Am J Roentgenol 1998; 171: 95-102.
  • Nishie M, Yoshida Y, Hirata Y, Matsunaga M. Generation of symptomatic palatal tremor is not correlated with inferior olivary hypertrophy. Brain 2002; 125: 1348-57.
  • Nitschke MF, Krüger G, Bruhn H, Klein C, Gehrking E, Wessel K, Frahm J, Vieregge P. Voluntary palatal tremor is associated with hyperactivation of the inferior olive: a functional magnetic resonance imaging study. Mov Disord 2001; 16: 1193-5.
There are 17 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Case Reports
Authors

Hatice Balaban

Özlem Kayım Yıldız

İbrahim Öztoprak

Ertuğrul Bolayır

Suat Topaktaş

Publication Date February 16, 2012
Published in Issue Year 2012Volume: 34 Issue: 3

Cite

AMA Balaban H, Kayım Yıldız Ö, Öztoprak İ, Bolayır E, Topaktaş S. Symptomatic palatal tremor is not limited to the activity of guillain-mollaret triangle: A functional magnetic resonance imaging case study. CMJ. December 2012;34(3):347-351.