title: Oculopalatal tremor: variations on a theme by Guillain and Mollaret.
abstract: BACKGROUND
  Oculopalatal tremor (OPT) is a delayed complication of a brainstem lesion, characterized by involuntary contractions of the soft palate associated with a synchronized ocular pendular nystagmus. MRI reveals inferior olivary nucleus hypersignal/hypertrophy (IONH). Our objective was to refine the clinical profile of patients with OPT and to report a few oddities in both presentation and evolution.
  
  
  METHODS
  We performed a retrospective study of patients diagnosed with OPT and a literature search.
  
  
  RESULTS
  From our database, we retrieved 5 men and 3 women with a diagnosis of OPT. Eighty-two patients with OPT were retrieved from the literature and were compiled with our series. The average age was 54 years and there was a male predominance. Brainstem vascular lesion was the most common etiology (80%). Prominent vertical pendular nystagmus was found in 90%. Dissociated nystagmus was mostly associated to unilateral contralateral IONH on MRI, while bilateral symmetrical nystagmus was due to a bilateral IONH in the majority of cases. Three oddities were found amongst our 8 patients: prominent nystagmus ipsilateral to IONH; disappearance of IONH on MRI despite persisting nystagmus, and asymptomatic OPT.
  
  
  CONCLUSIONS
  The clinical profile of OPT is rather stereotyped. Rarely do patients deviate from the classical description of OPT.
authors.affiliation: Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland.
authors.forename: Liuna
authors.initials: L
authors.lastname: Jang
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Borruat
mesh_terms: D000328:Adult; D000368:Aged; D001933:Brain Stem / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009759:Nystagmus, Pathologic / Q000209:etiology*; D012189:Retrospective Studies; D014202:Tremor / Q000150:complications* / Q000209:etiology / Q000473:pathology