title: Psychogenic palatal tremor may be underrecognized: reappraisal of a large series of cases.
abstract: BACKGROUND
  Palatal tremor is characterized by rhythmic movements of the soft palate and can be essential or symptomatic. Some patients can have palatal movements as a special skill or due to palatal tics. Psychogenic palatal tremor is recognized but rarely reported in the literature.
  
  
  METHODS
  We retrospectively evaluated all patients with palatal tremor seen in our center over a period of 10 years.
  
  
  RESULTS
  Of 17 patients with palatal tremor, we identified 10 patients with isolated palatal tremor. In 70% of those the diagnosis of psychogenic palatal tremor could be made. Of the remainder, 2 had palatal tics and 1 essential palatal tremor.
  
  
  CONCLUSIONS
  We suggest that psychogenic palatal tremor may be underrecognized and propose that targeted clinical examination of positive signs for psychogenic movement disorders in these patients is essential. The correct identification of such patients has important clinical and scientific implications.
authors.affiliation: Sobell Department of Motor Neuroscience and Movement Disorders, University College London (UCL) Institute of Neurology, London, United Kingdom.
authors.forename: Maria
authors.initials: M
authors.lastname: Stamelou
authors.affiliation: Sobell Department of Motor Neuroscience and Movement Disorders, University College London (UCL) Institute of Neurology, London, United Kingdom.
authors.forename: Tabish A
authors.initials: TA
authors.lastname: Saifee
authors.affiliation: Sobell Department of Motor Neuroscience and Movement Disorders, University College London (UCL) Institute of Neurology, London, United Kingdom.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Edwards
authors.affiliation: Sobell Department of Motor Neuroscience and Movement Disorders, University College London (UCL) Institute of Neurology, London, United Kingdom.
authors.forename: Kailash P
authors.initials: KP
authors.lastname: Bhatia
mesh_terms: D000328:Adult; D017668:Age of Onset; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D004576:Electromyography; D005260:Female; D005904:Glial Fibrillary Acidic Protein / Q000235:genetics; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications; D010156:Palatal Muscles / Q000503:physiopathology*; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology*; D020323:Tics / Q000209:etiology; D014202:Tremor / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology*
chemical_list: D018726:Anti-Dyskinesia Agents; D005904:Glial Fibrillary Acidic Protein; D019274:Botulinum Toxins, Type A