ABSTRACT
CASE PRESENTATION A 47-year-old man presented one-and-a-half years after a right midbrain hemorrhage ( Figure 14.1 ) with involuntary left-side jerking movements, a left hemisensory deficit, and gait difficulty. Since the stroke, he also experienced vertigo, diplopia, dysarthria, and sleep apnea. Several months into rehabilitation, he noticed clicking noises in his ears. On examination, there was dysarthria, dysmetric saccades, nystagmus, marked left hemisensory deficit to proprioception and vibration, left sided dyssynergia, dysmetria, and ataxia. Isolated rhythmic contractions of the soft palate at about 2 Hz were seen, characteristic of palatal tremor (see video, Case 14 ).
