Zheng B, Wang J, Huang XQ, Chen Z, Gu GF, Luo XJ. Bilateral Hypertrophic Olivary Degeneration after Pontine Hemorrhage: A Case Report. World J Clin Cases 2022; 10(1): 289-295 [PMID: 35071530 DOI: 10.12998/wjcc.v10.i1.289]
Corresponding Author of This Article
Jian Wang, MD, Doctor, Department of Neurology, Yaan People’s Hospital, No. 358 Chenghou Road, Yaan 625000, Sichuan Province, China. wangjian0724@126.com
Research Domain of This Article
Neurosciences
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jan 7, 2022; 10(1): 289-295 Published online Jan 7, 2022. doi: 10.12998/wjcc.v10.i1.289
Bilateral Hypertrophic Olivary Degeneration after Pontine Hemorrhage: A Case Report
Bo Zheng, Jian Wang, Xue-Qiong Huang, Zhao Chen, Gang-Feng Gu, Xiao-Jing Luo
Bo Zheng, Jian Wang, Zhao Chen, Gang-Feng Gu, Xiao-Jing Luo, Department of Neurology, Yaan People’s Hospital, Yaan 625000, Sichuan Province, China
Xue-Qiong Huang, Department of Oncology, Yaan People’s Hospital, Yaan 625000, Sichuan Province, China
Author contributions: Zheng B, Wang J, Huang XQ and Gu GF reviewed the literature and contributed to manuscript drafting; Chen Z analyzed and interpreted the imaging findings; Luo XJ was responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Supported byScientific Research Project of Sichuan Hospital Management and Development Research Center, No. SCYG2019-25; Key Technology Plan of Yaan City, No.21KJH0006.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: May 10, 2021 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
Abstract
BACKGROUND
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.
CASE SUMMARY
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.
CONCLUSION
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.
