August 5, 2026

@michaelokun

One of the discussions that really resonated with me at the Aspen Movement Disorders Course centered on a deceptively simple question: is "palatal myoclonus" really myoclonus? Joe Jankovic made the case that myorhythmia may actually be a more accurate term, as the movements are slow and remarkably rhythmic, yet the palate lacks the agonist-antagonist muscle pairs that define classic tremor. Mark Hallett and I in past Aspen course years found ourselves playfully pondering whether a Yiddish-inspired description such as "tremor-ish" might better capture the clinical reality than forcing these movements into imperfect categories. The conversation also highlighted how our understanding continues to evolve. What was once broadly labeled palatal myoclonus is now recognized to include several distinct entities, including primary palatal hyperkinesia with ear clicking, which is increasingly appreciated as often representing a functional movement disorder, alongside multiple forms of secondary palatal movement disorders resulting from structural lesions. These are the kinds of conversations that make Aspen special. They remind us that movement disorders are rarely static, and that thoughtful debate over terminology often reflects much deeper advances in understanding biology, diagnosis, and ultimately patient care.