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Quivering Chin Syndrome
A 4-year-old neurotypical boy presented with unprovoked, involuntary intermittent tremulousness of the chin lasting for few minutes to hours, noted from 18 months of age with no family history ([Video 1]). These movements were absent during sleep. The neurological examination, neuroimaging, and electroencephalography was otherwise normal. Surface electromyography of the mentalis muscle demonstrated a tremor frequency of 8 Hz ([Video 2]). Quivering chin syndrome is a rare movement disorder. It may be sporadic or inherited in an autosomal dominant fashion with incomplete penetrance with locus on chromosome 9(9q13-q21). These involuntary, paroxysmal, rhythmic, movements of the chin and/or lower lip may last from seconds to hours. Episodes occur spontaneously or may be precipitated by stress and emotion. Usually no treatment is required. When indicated, injection of low-dose botulinum toxin into the mentalis muscle or low-dose clonazepam may be helpful. Recognition of this rare entity is important to avoid unnecessary investigations.
Video 1 Quivering chin syndrome with involuntary low-amplitude high-frequency tremor affecting the chin.
Video 2 Surface electromyography (EMG) of the mentalis muscle demonstrates a tremor frequency of 8 Hz. Gain 100 μv/div; 100 ms/div along with clinical correlate.
R.S. prepared the manuscript, S.S. provided critical appraisal.
Received: 08 September 2022
Accepted: 14 October 2022
Article published online:
31 December 2022
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- 1 Danek A. Geniospasm: hereditary chin trembling. Mov Disord 1993; 8 (03) 335-338
- 2 McGrath CP, Gorman KM, King MD. A quiver of the chin. Pediatr Neurol 2019; 99: 91