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Images in Neurology
September 2008

Progressive Ataxia and Palatal Tremor

Arch Neurol. 2008;65(9):1248-1249. doi:10.1001/archneur.65.9.1248

An otherwise healthy middle-aged woman was experiencing gait instability. Neurological examination revealed truncal ataxia. Family history was negative. Brain and spinal cord 1.5-T magnetic resonance imaging (MRI) was performed and yielded normal results. Thyroid hormone, vitamin B12, and folic acid levels were normal. During the next 4 years, her walking difficulties progressed. She also developed palatal tremor. Repeated brain MRI revealed T2 hyperintensities in both olivary nuclei. Therefore, she was referred to our institution for further evaluation.

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