Rinsho Shinkeigaku (Clinical Neurology)

Case Report

An elderly man with progressive ataxia and palatal tremor presenting with dizziness and oculopalatal tremor

Yuka Tsukahara, M.D.1), Keisuke Suzuki, M.D., Ph.D.1), Norito Kokubun, M.D., Ph.D.1), Toshiki Nakamura, M.D., Ph.D.2), Hidehiro Takekawa, M.D., Ph.D.1) and Koichi Hirata, M.D., Ph.D.1)

1)Department of Neurology, Dokkyo Medical University
2)Department of Neurology, Rehabilitation Amakusa Hospital

A 74-year-old man was referred to our department for dizziness and progressive unsteady gait over 6 years. His family history was unremarkable. Neurological examination showed dysarthria, saccadic eye movement, palatal tremor (1.7 Hz)-synchronous with rotational ocular movement, and truncal ataxia. T2-weighted magnetic resonance imaging (MRI) of the brain revealed hyperintense and hypertrophic bilateral inferior olivary nuclei at the medulla and mild cerebellar atrophy. On the basis of neurological findings of oculopalatal tremor and cerebellar ataxia with brain MRI findings, the diagnosis of progressive ataxia and palatal tremor (PAPT) was made. PAPT should be included in differential diagnosis of dizziness observed in elderly individuals.
Movie legends
Oculopalatal tremor, palatal tremor with synchronous rotational ocular movement (1.7 Hz), is observed.
Full Text of this Article in Japanese PDF (522K)

(CLINICA NEUROL, 56: 560|564, 2016)
key words: progressive ataxia and palatal tremor, oculopalatal tremor, hypertrophy of the inferior olivary nuclei, truncal ataxia, dizziness

(Received: 6-Apr-16)