phenylephrine-hydrochloride and Tremor

In this study, we report a rare case of an adult patient with essential palatal tremors (EPT) presenting as nasal clicks, instead of otic clicks or objective pulsatile tinnitus in common EPT.. Nasal endoscopic examination and EMG recordings of the soft palate muscles were performed to confirm the source of the clicks. Initial treatment with lidocaine provided symptomatic relief for four hours. The patient was then treated with four simultaneous injections of 12.5 U of botulinum toxin in four different sites of the soft palate. Palatal tremors and clicks completely disappeared within three months of treatment.. To our knowledge, this is the first case of EPT that presented with nasal clicks. We recommend that otolaryngologists should expect this rare occurrence in the clinical setting, and handle patients presenting with such symptoms with care and compassion in order not to worsen their psychological status.

Topics: Botulinum Toxins; Electromyography; Endoscopy; Follow-Up Studies; Humans; Injections, Intralesional; Male; Middle Aged; Nose; Palate, Soft; Quality of Life; Rare Diseases; Risk Assessment; Tinnitus; Tomography, X-Ray Computed; Treatment Outcome; Tremor

The identification of the intentionality of movement is a key-aspect for the development of brain-computer interfaces (BCIs) applicable to daily life in neurological patients. We present a novel method of processing of electroencephalography (EEG) signals for the extraction of movement intention in neurological patients with upper limb tremor. This method is based on event-related EEG desynchronization, considering α (8-12 Hz), β (13-30 Hz), and γ (30-40 Hz) bands. We have analyzed the EEG signals from the sensorimotor areas of 4 neurological patients presenting an upper limb tremor (grade 1 to 3/4) and executing successive finger-to-nose movements. A Quality Parameter (QP) for the detection of intentionality of movement has been extracted, by considering: (a) the changes in the β²/α and β/α ratio (representing bursts of β-γ frequencies) during the pre-movement period; (b) an appropriate threshold predicting the movement; (c) the number of movements executed. This QP allows the prediction of the voluntary movement with a probability between 70% and 90%. This method could be implemented in a wearable BCI to detect the intentionality of movement and could be used, for instance, to trigger the electrical stimulation in selected muscles of upper limbs with the aim of blocking the emergence of tremor.

Topics: Electroencephalography; Female; Fingers; Humans; Intention; Male; Middle Aged; Movement; Nose; Sensory Thresholds; Task Performance and Analysis; Tremor