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Liberty Times / Liberty Times 2009-07-09 06:00
Reporter Cai Zhangsheng / Hsinchu City Report
A 46-year-old man suffered from tinnitus for as long as two years. Recently, the ringing in his ears grew increasingly louder, making him feel as though the sound was constantly drilling out of his brain. It didn’t stop even at night, leaving him restless all day, unable to work, and on the verge of a mental breakdown. A neurological outpatient examination revealed it to be a rare case of primary palatal myoclonus.
Dr. Guo Canming, a neurologist at the Hsinchu Hospital under the Department of Health, stated that when he placed a stethoscope around the patient’s ears, he could indeed hear the clicking sound the patient described.
When the patient was asked to focus straight ahead, no nystagmus was observed. Upon opening his mouth, rhythmic spasms of the palatal muscles were detected. Other neurological examinations showed no abnormalities, and a brain MRI scan also yielded normal results. It was only after these tests that primary palatal myoclonus was diagnosed.
There are many causes of tinnitus, which can generally be divided into subjective and objective tinnitus. In this case, the patient’s tinnitus could be heard by others, classifying it as objective tinnitus. Palatal myoclonus is further categorized as primary or secondary, most commonly occurring in individuals aged 40 to 70, with a higher incidence in women than men. The rhythmic spasms of the soft palate muscles occur at a rate of about 60 to 180 times per minute, leading to difficulties in speech and swallowing. Sometimes, it is accompanied by eye twitching and typically persists even during sleep.
The exact cause of this condition remains unknown. Pathologically, hypertrophy of the inferior olive nucleus is often observed, which may disrupt the regulatory function of the olivocerebellar system on the brainstem, triggering the disorder. For diagnosis, a stethoscope can be used to listen to the external ear canal, and by asking the patient to open their mouth, palatal muscle spasms can be detected. The frequency of these spasms matches that of the tinnitus, which can serve as a preliminary diagnosis.
Clinically, palatal electromyography and brain MRI scans can aid in differential diagnosis. Treatment options include anticholinergic drugs, antiepileptic medications, sedatives, and even local botulinum toxin injections, all of which can provide relief.
Source: http://n. yam. com/ tlt/ healthy/ 200907/ 20090709077558. html
Jaw Myoclonus: Ticking through the Brain
Reporter Cai Zhangsheng / Hsinchu City Report
A 46-year-old man suffered from tinnitus for as long as two years. Recently, the ringing in his ears grew increasingly louder, making him feel as though the sound was constantly drilling out of his brain. It didn’t stop even at night, leaving him restless all day, unable to work, and on the verge of a mental breakdown. A neurological outpatient examination revealed it to be a rare case of primary palatal myoclonus.
Dr. Guo Canming, a neurologist at the Hsinchu Hospital under the Department of Health, stated that when he placed a stethoscope around the patient’s ears, he could indeed hear the clicking sound the patient described.
When the patient was asked to focus straight ahead, no nystagmus was observed. Upon opening his mouth, rhythmic spasms of the palatal muscles were detected. Other neurological examinations showed no abnormalities, and a brain MRI scan also yielded normal results. It was only after these tests that primary palatal myoclonus was diagnosed.
There are many causes of tinnitus, which can generally be divided into subjective and objective tinnitus. In this case, the patient’s tinnitus could be heard by others, classifying it as objective tinnitus. Palatal myoclonus is further categorized as primary or secondary, most commonly occurring in individuals aged 40 to 70, with a higher incidence in women than men. The rhythmic spasms of the soft palate muscles occur at a rate of about 60 to 180 times per minute, leading to difficulties in speech and swallowing. Sometimes, it is accompanied by eye twitching and typically persists even during sleep.
The exact cause of this condition remains unknown. Pathologically, hypertrophy of the inferior olive nucleus is often observed, which may disrupt the regulatory function of the olivocerebellar system on the brainstem, triggering the disorder. For diagnosis, a stethoscope can be used to listen to the external ear canal, and by asking the patient to open their mouth, palatal muscle spasms can be detected. The frequency of these spasms matches that of the tinnitus, which can serve as a preliminary diagnosis.
Clinically, palatal electromyography and brain MRI scans can aid in differential diagnosis. Treatment options include anticholinergic drugs, antiepileptic medications, sedatives, and even local botulinum toxin injections, all of which can provide relief.
Source: http://n. yam. com/ tlt/ healthy/ 200907/ 20090709077558. html