Velo‐pharyngo‐laryngeal myoclonus: Evaluation of objective tinnitus and extrathoracic airway obstruction

Abstract

Velo‐pharyngo‐laryngeal myoclonus, the rapid, rhythmic contraction of muscles of the pharynx and larynx, is a rare neurological manifestation of numerous disease processes affecting the cerebellum. In its most common form, palatal myoclonus, this disease frequently presents to the otolaryngologist as objective tinnitus. Impedance audiometry provides a useful means of verifying suspected palatal myoclonic activity through recorded changes in the middle ear pressure, as mediated by muscle activity at the proximal portion of the eustachian tube. A very rare case of velo‐pharyngo‐laryngeal myoclonic with clonic contraction of the laryngeal adductors and subsequent extrathoracic airway obstruction is presented. Tracheostomy provided immediate symptomatic relief of dyspnea.

2385 Meta-analysis of the head impulse test (HIT) and head impulse test, nystagmus, test of skew (HINT) in the diagnosis of stroke and peripheral vertigo

“…Discussion Subacute stridor may be due to pathological upper motor neurone activation of the branchial motor component of the vagal nerves with this person's background brain injury. 1 Tight acute midline cord positioning and myoclonus may be unusually caused by bilateral recurrent laryngeal nerve lesions secondary to changes in intracranial pressure, 2 3 but is not the favoured sole mechanism here. Botulinum toxin therapy could provide benefit but may compromise a future safe swallow.…”

“…1 Nigel TH Khoo*, 2 Angelique Antoniou, 1,3 Objectives Refractive error has long been thought to be a cause for headache, however, historical research on this topic has major methodical limitations.…”

“…1 Suyi Ooi*, 2 Grace Phillips, 3 Tanya Tang, 1,4 Luke Chen, 1 Anthony Fok, 1 John Ly, 1,5 Henry Ma, 1,5 Thanh Phan. 1 Department of Neurology, Monash Health, Clayton, VIC, Australia; 2 Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia; 3 Department of Neurology, Peninsula Health, Frankston, VIC, Australia;…”

“…1 Anivartha Herur*, 1,2 Michael H Barnett, 1 Andie S Lee, 1,3 Benjamin Jonker, 1 Lauren Troy, 3 Yael Barnett, 1,2 Heidi N Beadnall. 1 Royal Prince Alfred Hospital, Sydney, NSW, Australia; This case highlights the complexities associated with diagnosing granulomatous disease even with access to multimodal imaging and biopsy sites, and the need to revisit the diagnosis if there are atypical features.…”

“…1,2 Fu-Chu FC Chiang*, 1 Robert RMT Thomas, 1 Meng MT Tan, 1 Gaurav GS Singh*. Objectives To establish the diagnostic yield of electroencephalogram (EEG) and other investigations for evaluation of limbic encephalitis in patients with new onset psychiatric symptoms.…”