Palato-ocular Synchrony in Oculopalatal Tremor

This is a patient with OPT due to a pontine hemorrhage, and although she did have torsional pendular nystagmus, it was very subtle. However, with eyelid closure, much larger vertical ocular oscillations could be seen, which were in fact synchronous with her palatal tremor. This finding, sometimes referred to as palato-ocular synchrony, should be sought in patients in whom OPT is suspected, especially when pendular nystagmus is subtle or absent completely.