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Images in Neurology
January 2016

Dancing Jaw and Dancing Eyes

Author Affiliations
  • 1Division of Cognitive and Restorative Neurology, Department of Neurology, Inselspital, University Hospital Bern, and University of Bern, Bern, Switzerland
  • 2Perception and Eye Movement Laboratory, Department of Clinical Research, University of Bern, Bern, Switzerland
  • 3Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern, and University of Bern, Bern, Switzerland
  • 4Department of Otorhinolaryngology, Inselspital, University Hospital Bern, and University of Bern, Bern, Switzerland
JAMA Neurol. 2016;73(1):122. doi:10.1001/jamaneurol.2015.2299

A man in his early 30s experienced infratentorial bleeding of unknown etiology. Two weeks after this occurrence, he manifested rhythmic horizontal jaw and eye movements (Video). About 5 weeks after the patient’s hemorrhage he was observed to have pendular nystagmus and soft-palate oscillations with a frequency of 3 Hz. Fiberoptic laryngoscopy examination revealed rhythmic movements of the pharynx, root of the tongue, and plicae aryepiclotticae (Video). A diagnosis of oculopalatal tremor was made on the basis of the clinical observations. Findings from the magnetic resonance imaging examination done 8 weeks after the patient’s initial brainstem injury revealed bilateral T2-weighted hyperintense signal changes at the level of the lower olivary nuclei and of the inferior cerebellar peduncles (Figure), corresponding to a disruption of the inhibitory dentato-rubro-olivary pathway (the so-called Guillain-Mollaret triangle).1

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