Successful Treatment of Essential Palatal Tremor Lasting Over a Long Term with a Rare Application of Botulinum Toxin in a Child






How to Cite This Article: Eryılmaz A, Başal Y, Günel C, Ozkul A, Tosun A. Successful Treatment of Essential Palatal Tremor Lasting
Over a Long Term with a Rare Application of Botulinum Toxin in a Child. Iran J Child Neurol. Autumn 2015;9(4): 75-77.



Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent mental health disorders. In recent years, the impacts of various micronutrients on ADHD have been studied. However, vitamin D has received much less attention. This study was aimed at evaluating the association and level of

serum vitamin D in children with ADHD.

Materials & Methods

This case-control study was carried out, in 2012, on 6 to 12 yr-old children. Thirty-seven were children with ADHD in the cases group and another 37 healthy children were in the control group. Venous blood sample was drawn from each child to measure the serum level of vitamin D. Other variables were compared as well.


The mean serum vitamin D level of children with ADHD (19.11±10.10 ng/ml) was significantly lower than that of the control group (28.67±13.76 ng/ml) (P<0.001).


Deficiency of vitamin D has been proved in various psychiatric diseases. This study evidenced a significantly low level of serum vitamin D in children with ADHD. This suggests the need for regularly monitoring of serum vitamin D levels and treatment of patients with vitamin D deficiencies.


Botulinum toxin; Child; Essential palatal tremor

Full Text:




Zadikoff C, Lang AE, Klein C. The ‘essentials’ of essential palatal tremor: a reappraisal of the nosology. Brain 2006 Apr;129(Pt 4):832-40.

Samuel M, Kleiner-Fisman G, Lang AE. Voluntary control and a wider clinical spectrum of essential palatal tremor. Mov Disord 2004 Jun;19(6):717-9.

Carman KB, Ozkan S, Yarar C, Yakut A.Essential palatal tremor treated with botulinum toxin.Pediatr Neurol 2013 May;48(5):415-7

Deuschl G, Mischke G, Schenck E, et al. Symptomatic and essential rhythmic palatal myoclonus. Brain 1990; 113:1645-72.

Elziere M, Roman S, Nicollas R, et al. Objective tinnitus associated with essential palatal myoclonus: report in a child. Int Tinnitus J 2007;13:157-8.

MacDonald JT. Objective tinnitus due to essential palatal tremor in a 5-year-old. Pediatr Neurol 2007;36:175-6.

Jero J, Salmi T. Palatal myoclonus and clicking tinnitus in a 12-year old girl—case report. Acta Otolaryngol Suppl 2000; 543:61-2.

Krause E, Leunig A, Klopstock T, et al. Treatment of essential palatal myoclonus in a 10-year-old girl with botulinum neurotoxin. Otol Neurotol 2006;27:672-5.

Ensink RJ, Vingerhoets HM, Schmidt CW, et al. Treatment for severe palatoclonus by occlusion of the eustachian tube. Otol Neurotol 2003;24:714-6.

Pal PK, Lakshmi PS, Nirmala M. Efficacy and complication of botulinum toxin injection in palatal myoclonus: experience from a patient. Mov Disord 2007;22:1484-6.

Krause E1, Heinen F, Gürkov R. Difference in outcome of botulinum toxin treatment of essential palatal tremor in children and adults. Am J Otolaryngol 2010 Mar- Apr;31(2):91-5.

Jamieson DR, Mann C, O’ Reilly B, Thomas AM. Ear clicks in palatal tremor caused by activity of the levator veli palatini. Neurology 1996;46:1168e9.

Campistol-Plana J1, Majumdar A, Fernández-Alvarez E. Palatal tremor in childhood: clinical and therapeutic considerations. Dev Med Child Neurol.



  • There are currently no refbacks.

Copyright (c) 2015 Iranian Journal of Child Neurology