We read with great interest the article by Brinar et al1 reporting a case of progressive ataxia and palatal tremor. They described a middle-aged woman with progressive cerebellar ataxia associated with severe palatal tremor. Magnetic resonance imaging showed atrophy of the vermis and both cerebellar hemispheres as well as bilateral symmetrical hyperintensity of olivary nuclei. They noted that on examination, the patient showed no signs of pyramidal or sensory involvement but had the Romberg sign and walking instability.
Teive HA, Munhoz RP. Progressive Ataxia, Palatal Tremor, and the Romberg Sign. Arch Neurol. 2009;66(2):284-285. doi:10.1001/archneurol.2008.550