Spontaneous Resolution of Pharyngeal Myoclonus in a Child: An Uncommon Case With Objective Clicking Sounds

Abstract

Pharyngeal myoclonus is a rare movement disorder characterized by rhythmic pharyngeal contractions, typically reported in adults with neurological lesions and rarely in children. We report a seven-year-old girl who experienced involuntary clicking sounds localized to the right ear. Nasopharyngoscopy revealed pharyngeal myoclonus without structural abnormalities, and brain and laryngeal MRI were unremarkable. No intervention was performed, and symptoms resolved spontaneously over 12 months, coinciding with increased familial support in response to suspected psychosocial stress. This case highlights the benign, self-limiting nature of pediatric pharyngeal myoclonus and suggests that conservative management may be appropriate, particularly when environmental or psychological factors are the suspected contributors.

Keywords: functional movement disorder; pediatric case; pharyngeal myoclonus; psychosocial stressors; spontaneous resolution.

Figure 1. Normal axial T2-weighted brain MRI

Axial T2-weighted MRI demonstrating normal cerebral anatomy at the level of the lateral ventricles. The image shows well-demarcated gray and white matter differentiation, normal ventricular size, and no evidence of mass effect, edema, or abnormal signal intensity. No structural abnormalities were observed.

Figure 2. Normal brainstem on axial T2-weighted MRI

Axial T2-weighted MRI at the level of the midbrain and pons. The brainstem structures, including the cerebral peduncles, midbrain tegmentum, and pontine base, appear symmetrical and without abnormal signal changes. No evidence of infarction, demyelination, or compression was observed  supporting the absence of brainstem pathology.