Oculopalatal tremor with palato-ocular synchrony during eye closure

Although patients with oculopalatal tremor (OPT) typically have both pendular nystagmus (oculo-) and palatal tremor (-palatal), sometimes only one or the other may be present. However, if pendular nystagmus is present or absent, large vertical ocular oscillations (that are synchronous with palatal tremor) can usually be brought on by active eye closure. This finding is especially noticeable in this patient with a right lower motor facial palsy as the globe can be directly visualized. The patient had a right vestibular schwannoma, and the etiology of OPT (and the facial palsy) was related to the resection.