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Symptomatic palatal myoclonus with ear click after tick-borne meningoencephalitis

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Abstract

We present a case of a 39-year-old patient, who was diagnosed and treated for a tick-borne meningoencephalitis. Three months after the treatment he started to complain of annoying, cracks-resembling, rhythmical sounds, coming from the inside of his head to both his ears. Physical examination revealed rhythmical oscillations of the soft palate with a frequency of 100–120 per minute and a clock ticking noise synchronic with the palate tremor. Electromyography revealed continuous motor unit activity at rest in the tensor veli palatini muscle. Palatal myoclonus (PM) as a result of tick-borne meningoencephalitis was diagnosed. Treatment with several medications was started with no effect, then botulinum toxin was administered under EMG guidance to both sides of the patient’s soft palate with great improvement. A 5-year follow-up and continuation of botulinum toxin injections with only minor and reversible side effects proved the treatment efficacy and safety. In the article we present a case of symptomatic palatal myoclonus with ear click and shortly discuss its aetiology, types and treatment options. We also stress the efficacy and safety of PM treatment with repetitive injections of botulinum toxin.

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Authors and Affiliations

  1. Department of Neurology, Medical University of Bialystok, 24 A Sklodowska-Curie Str., 15-267 , Bialystok, Poland

    Robert Pogorzelski & Wieslaw Drozdowski

  2. Department of Otorhinolaryngology, Medical University of Bialystok, Bialystok, Poland

    Marek Rogowski

Authors
  1. Robert Pogorzelski
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  2. Wieslaw Drozdowski
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  3. Marek Rogowski
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Correspondence to Robert Pogorzelski.

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Pogorzelski, R., Drozdowski, W. & Rogowski, M. Symptomatic palatal myoclonus with ear click after tick-borne meningoencephalitis. Eur Arch Otorhinolaryngol 263, 711–713 (2006). https://doi.org/10.1007/s00405-006-0053-7

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  • DOI: https://doi.org/10.1007/s00405-006-0053-7

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