Palatal tremor (or palatal myoclonus) is a rare movement disorder affecting the soft palate. The essential, or idiopathic form, usually affects children aged between 6 and 9 years and resolves spontaneously after between 3 months and 5 years. There is involuntary rhythmic jerking of the soft palate in an otherwise neurologically normal child, and clicking in the ears audible to the child and to an observer with, or sometimes without, a stethoscope. In Barcelona ( Developmental Medicine and Child Neurology2006;48:982–4OpenUrlCrossRefPubMedWeb of Science) four children were treated with piracetam and all lost the palatal tremor within a month of starting treatment at doses between 100 and 300 mg/kg/day. One child relapsed on stopping treatment but responded to a further course.

There is a suggestion that periodontal disease in pregnancy might increase the risks of preterm birth, preeclampsia and low birthweight. Now a multicentre trial in the USA ( New England Journal of Medicine2006;355:1885–94OpenUrlCrossRefPubMedWeb of Science; see also editorial, ibid: 1925–7) has shown that treatment of periodontal disease is successful in dental terms but probably does not improve obstetric outcomes. A total of 823 women with periodontal disease were randomised to be treated with scaling and root planing, with monthly tooth polishing and oral hygiene instruction, either before 21 weeks gestation or after the birth. Treatment improved the periodontal …