Published online Jan 7, 2022. doi: 10.12998/wjcc.v10.i1.289
Peer-review started: May 10, 2021
First decision: October 16, 2021
Revised: November 9, 2021
Accepted: November 29, 2021
Article in press: November 29, 2021
Published online: January 7, 2022
Processing time: 233 Days and 18.2 Hours
Hemorrhage lesions may lead to bilateral hypertrophic olivary degeneration (HOD) through interruption of the dentato-rubral-olivary pathway. The pathological features of HOD are unusual neuronal trans-synaptic degenerative changes.
A 56-year-old female was admitted to our hospital because her lower extremities and left upper ones were unable to move for 3 mo, and the swelling of her right lower extremities became worse 3 days ago. She had a hypertension history. Her characteristic clinical manifestations are palatal myoclonus and nystagmus. The patient’s magnetic resonance imaging (MRI) results showed that she had bilateral HOD after an acute pontine hemorrhage. She was given symptomatic and supportive treatment. The gabapentin, the memantine and the trihexyphenidyl were taken twice a day each. The rehabilitation and psychotherapy were implemented. After 3 months of treatment, her eye symptoms improved.
Bilateral HOD is a rare phenomenon after pontine hemorrhage. The key to diagnosis lies in the clinical manifestations and MRI results.
Core Tip: Bilateral hypertrophic olivary degeneration (HOD) after pontine hemorrhage is rare. The clinical manifestations and MRI results of HOD are varied, which make it important to monitor the patient and identify the changes in MRI results. Generally speaking, the mechanism leading to HOD is still unclear, and the effect of symptomatic treatment for some patients is not satisfactory.