Hypertrophic olivary degeneration after brainstem haemorrhage – A case report

Abstract

Insidious neurological deterioration may develop months to years after a lesion involving the Guillain-Mollaret triangle due to hypertrophic olivary degeneration. Lesions involving the dento-rubro-olivary pathways may lead to pseudo-hypertrophy of the inferior olivary nucleus with subsequent neuronal degeneration. A number of clinical syndromes have been linked to hypertrophic olivary degeneration. Cases of gait ataxia, Holmes tremor and symptomatic palatal and oculo-palatal tremor were associated with this condition. We hereby report a case of disabling Holmes tremor and gait ataxia associated with palatal tremor in a 45-year-old patient with a prior brainstem haemorrhage.

Keywords

• hypertrophic olivary degeneration
• brainstem haemorrhage
• holmes tremor
• palatal tremor
• case-report