The development of glossopharyngeal breathing and palatal myoclonus in a 29 year old after scuba diving

Abstract

Palatal myoclonus is a rare movement disorder characterized by brief, rhythmic involuntary movements of the soft palate. Palatal myoclonus is further subdivided into “essential palatal tremor” (EPT) and “symptomatic palatal tremor” (SPT). EPT is characterized by involvement of the tensor veli palatini, myoclonus that might persist during sleep, as well as ear clicks, usually the patient’s presenting complaint. The MRI and neurological exam are normal in EPT. SPT is characterized by involvement of the levator veli palatini and myoclonus which consistently perseveres during sleep. The MRI shows olivary hypertrophy and clinical features may include ataxia, dysarthria and nystagmus, depending on the size of the lesion1. Glossopharyngeal breathing is a technique used by deep-sea divers to increase lung vital capacity, which is also useful in patients with ventilator dependence from poliomyelitis and Duchenne muscular dystrophy. To date there have been no reported cases of palatal myoclonus and glossopharyngeal breathing occurring simultaneously. We present the case of a 29 year-old female with palatal myoclonus and glossopharyngeal breathing after scuba-diving.

Keywords

• glossopharyneal breathing
• palatal myoclous
• scuba diving