Continuous Involuntary Tut-Tutting: A Case Report
Authors: Koichi Tsunoda, Yohko Morita, Takao Yabe, Atsunobu Tsunoda, Maiko Saito
Journal: Annals of Internal Medicine (2014)

Letters20 May 2014Continuous Involuntary Tut-Tutting: A Case ReportKoichi Tsunoda, MD, PhD, Yohko Morita, MD, PhD, Takao Yabe, MD, PhD, Atsunobu Tsunoda, MD, PhD, and Maiko Saito, MDKoichi Tsunoda, MD, PhDFrom National Hospital Organization, National Tokyo Medical Center, National Institute of Sensory Organs, Tokyo, Japan; National Hospital Organization, National Tokyo Medical Center, Tokyo, Japan; Tokyo Metropolitan Hospital, Tokyo, Japan; Tokyo Medical and Dental University, Tokyo, Japan; and National Hospital Organization, Tokyo Medical Center, Tokyo, Japan.Search for more papers by this author, Yohko Morita, MD, PhDFrom National Hospital Organization, National Tokyo Medical Center, National Institute of Sensory Organs, Tokyo, Japan; National Hospital Organization, National Tokyo Medical Center, Tokyo, Japan; Tokyo Metropolitan Hospital, Tokyo, Japan; Tokyo Medical and Dental University, Tokyo, Japan; and National Hospital Organization, Tokyo Medical Center, Tokyo, Japan.Search for more papers by this author, Takao Yabe, MD, PhDFrom National Hospital Organization, National Tokyo Medical Center, National Institute of Sensory Organs, Tokyo, Japan; National Hospital Organization, National Tokyo Medical Center, Tokyo, Japan; Tokyo Metropolitan Hospital, Tokyo, Japan; Tokyo Medical and Dental University, Tokyo, Japan; and National Hospital Organization, Tokyo Medical Center, Tokyo, Japan.Search for more papers by this author, Atsunobu Tsunoda, MD, PhDFrom National Hospital Organization, National Tokyo Medical Center, National Institute of Sensory Organs, Tokyo, Japan; National Hospital Organization, National Tokyo Medical Center, Tokyo, Japan; Tokyo Metropolitan Hospital, Tokyo, Japan; Tokyo Medical and Dental University, Tokyo, Japan; and National Hospital Organization, Tokyo Medical Center, Tokyo, Japan.Search for more papers by this author, and Maiko Saito, MDFrom National Hospital Organization, National Tokyo Medical Center, National Institute of Sensory Organs, Tokyo, Japan; National Hospital Organization, National Tokyo Medical Center, Tokyo, Japan; Tokyo Metropolitan Hospital, Tokyo, Japan; Tokyo Medical and Dental University, Tokyo, Japan; and National Hospital Organization, Tokyo Medical Center, Tokyo, Japan.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5010-6 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: What Japanese speakers refer to as shitauchi involves a tongue movement similar to what English speakers refer to as “tut-tutting” but has a different connotation. In the Japanese social setting, this tongue clicking is equivalent to uttering a common 4-letter English obscenity.Objective: To report a case of continuous involuntary tut-tutting caused by a variant type of rhythmic palatal myoclonus.Case Report: An 80-year-old woman visited our clinic because of continuous involuntary tongue clicking for approximately a decade that prevented her from attending most social events. It occurred while she was active during the day but not during sleep. ...References1. Deuschl G, Mischke G, Schenck E, Schulte-Mönting J, Lücking CH. Symptomatic and essential rhythmic palatal myoclonus. Brain. 1990;113 Pt 6 1645-72. [PMID: 2276039] CrossrefMedlineGoogle Scholar2. Fabiani G, Teive HA, Sá D, Kay CK, Scola RH, Martins M, et al. Palatal myoclonus: report of two cases. Arq Neuropsiquiatr. 2000;58:901-4. [PMID: 11018829] CrossrefMedlineGoogle Scholar3. Vieregge P, Klein C, Gehrking E, Körtke D, Kömpf D. The diagnosis of ‘essential palatal tremor.’. Neurology. 1997;49:248-9. [PMID: 9222198] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From National Hospital Organization, National Tokyo Medical Center, National Institute of Sensory Organs, Tokyo, Japan; National Hospital Organization, National Tokyo Medical Center, Tokyo, Japan; Tokyo Metropolitan Hospital, Tokyo, Japan; Tokyo Medical and Dental University, Tokyo, Japan; and National Hospital Organization, Tokyo Medical Center, Tokyo, Japan.Disclosures: None. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L13-1161. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 20 May 2014Volume 160, Issue 10Page: 739KeywordsBoneBrainstemElectromyographyLesionsMagnetic resonance imagingMusclesMyoclonusSleepThyroidTongue ePublished: 20 May 2014 Issue Published: 20 May 2014 CopyrightCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...