Cargando…

Treatment of Palatal Myoclonus with Botulinum Toxin Injection

Palatal myoclonus is a rare cause of pulsatile tinnitus in patients presenting to the otolaryngology office. Rhythmic involuntary contractions of the palatal muscles produce the pulsatile tinnitus in these patients. Treatment of this benign but distressing condition with anxiolytics, anticonvulsants...

Descripción completa

Detalles Bibliográficos
Autores principales: Anis, Mursalin M., Pollak, Natasha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3816037/
https://www.ncbi.nlm.nih.gov/pubmed/24223317
http://dx.doi.org/10.1155/2013/231505
_version_ 1782289483053400064
author Anis, Mursalin M.
Pollak, Natasha
author_facet Anis, Mursalin M.
Pollak, Natasha
author_sort Anis, Mursalin M.
collection PubMed
description Palatal myoclonus is a rare cause of pulsatile tinnitus in patients presenting to the otolaryngology office. Rhythmic involuntary contractions of the palatal muscles produce the pulsatile tinnitus in these patients. Treatment of this benign but distressing condition with anxiolytics, anticonvulsants, and surgery has been largely unsuccessful. A few investigators have obtained promising results with botulinum toxin injection into the palatal muscles. We present a patient with palatal myoclonus who failed conservative treatment with anxiolytics. Unilateral injection of botulinum toxin into her tensor veli palatini muscle under electromyographic guidance resolved pulsatile tinnitus in her ipsilateral ear and unmasked pulsatile tinnitus in the contralateral ear. A novel method of following transient postinjection symptoms using a diary is presented in this study. Botulinum toxin dose must be titrated to achieve optimal results in each individual patient, analogous to titrations done for spasmodic dysphonia. Knowledge of the temporal onset of postinjection side effects and symptomatic relief may aid physicians in dose titration and surveillance. We present suggestions on titrating the botulinum toxin dose to optimal levels. A review of the literature on the use of botulinum toxin for palatal myoclonus and some common complications are discussed.
format Online
Article
Text
id pubmed-3816037
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher Hindawi Publishing Corporation
record_format MEDLINE/PubMed
spelling pubmed-38160372013-11-12 Treatment of Palatal Myoclonus with Botulinum Toxin Injection Anis, Mursalin M. Pollak, Natasha Case Rep Otolaryngol Case Report Palatal myoclonus is a rare cause of pulsatile tinnitus in patients presenting to the otolaryngology office. Rhythmic involuntary contractions of the palatal muscles produce the pulsatile tinnitus in these patients. Treatment of this benign but distressing condition with anxiolytics, anticonvulsants, and surgery has been largely unsuccessful. A few investigators have obtained promising results with botulinum toxin injection into the palatal muscles. We present a patient with palatal myoclonus who failed conservative treatment with anxiolytics. Unilateral injection of botulinum toxin into her tensor veli palatini muscle under electromyographic guidance resolved pulsatile tinnitus in her ipsilateral ear and unmasked pulsatile tinnitus in the contralateral ear. A novel method of following transient postinjection symptoms using a diary is presented in this study. Botulinum toxin dose must be titrated to achieve optimal results in each individual patient, analogous to titrations done for spasmodic dysphonia. Knowledge of the temporal onset of postinjection side effects and symptomatic relief may aid physicians in dose titration and surveillance. We present suggestions on titrating the botulinum toxin dose to optimal levels. A review of the literature on the use of botulinum toxin for palatal myoclonus and some common complications are discussed. Hindawi Publishing Corporation 2013 2013-10-08 /pmc/articles/PMC3816037/ /pubmed/24223317 http://dx.doi.org/10.1155/2013/231505 Text en Copyright © 2013 M. M. Anis and N. Pollak. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Anis, Mursalin M.
Pollak, Natasha
Treatment of Palatal Myoclonus with Botulinum Toxin Injection
title Treatment of Palatal Myoclonus with Botulinum Toxin Injection
title_full Treatment of Palatal Myoclonus with Botulinum Toxin Injection
title_fullStr Treatment of Palatal Myoclonus with Botulinum Toxin Injection
title_full_unstemmed Treatment of Palatal Myoclonus with Botulinum Toxin Injection
title_short Treatment of Palatal Myoclonus with Botulinum Toxin Injection
title_sort treatment of palatal myoclonus with botulinum toxin injection
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3816037/
https://www.ncbi.nlm.nih.gov/pubmed/24223317
http://dx.doi.org/10.1155/2013/231505
work_keys_str_mv AT anismursalinm treatmentofpalatalmyoclonuswithbotulinumtoxininjection
AT pollaknatasha treatmentofpalatalmyoclonuswithbotulinumtoxininjection