Palatal Myoclonus or Tremur of the throat / Palate is treatable! There is help! Rhythmic palatal myoclonus (RPM) is a rare movement disorder consisting of continuous synchronous jerks of the soft palate, muscles innervated by other cranial nerves and, rarely, trunk and limb muscles. From my knowledge of PM, after studying with The Carrick Institute in his movement disorder coarse, I have learned the location of the lesion is typically the inferior olivary nucleus in the brainstem, the central tegmental tract which connects the olive to the red nucleus or the dentate of the cerebellum. Its thought that the inferior olive enlarges and develops rhythmic discharges when it is denervated by the ipsilateral brainstem disease or contralateral cerebellum, and causes the PM. The inferior olive is thought to be one of the very few structures that is inhibited by the cerebellum via GABA. Most of the cerebellar output is excitatory via ACh. It would make sense that if this inhibition is lost, it would allow the inferior olive to depolarize closer to it's innate rhythm of 10 Hz. It usually develops secondary to brainstem or cerebellar disease (symptomatic RPM). Some patients, however, fail to show evidence of a structural lesion (essential RPM). A total of 287 cases with RPM from the literature including 210 cases with symptomatic and 77 cases with essential RPM have been reviewed and analysed statistically to look for criteria separating the two conditions. Patients with essential RPM usually have objective earclicks <b>…</b>