Integrative Rehabilitation for Hypertrophic Olivary Degeneration after Operation of Brain Stem Cavernous Malformation: A Case Report / 中国康复理论与实践

Objective To summarize the integrative rehabilitation treatment of traditional Chinese medicine (TCM) and Western medicine in hypertrophic olivary degeneration (HOD) secondary to the operation of brain stem cavernous malformation. Methods The clinical data of medication, rehabilitation and follow-up of a patient with HOD secondary to operation on brain stem cavernous malformation was retrospectively analyzed. Results Three months after operation, limb static and motor tremor, dysarthria, palate spasm, eye movement disorder and walking difficulty appeared. The patient was diagnosed as HOD according to clinical features and brain magnetic resonance imaging (MRI). He was treated with pertinence rehabilitation training combined with TCM including acupuncture and herbs. After integrative rehabilitation, he could stand and walk independently, the tremor was alleviated, the balance function improved, the activities of daily living improved, and the dosage of oral western medicine also decreased. Conclusion After intracranial surgery, secondary neurodegeneration and movement disorder may appear, and it could be improved by integrative rehabilitation treatment of TCM and Western medicine

Integrative Rehabilitation for Hypertrophic Olivary Degeneration after Operation of Brain Stem Cavernous Malformation: A Case Report / 中国康复理论与实践

Objective To summarize the integrative rehabilitation treatment of traditional Chinese medicine (TCM) and Western medicine in hypertrophic olivary degeneration (HOD) secondary to the operation of brain stem cavernous malformation. Methods The clinical data of medication, rehabilitation and follow-up of a patient with HOD secondary to operation on brain stem cavernous malformation was retrospectively analyzed. Results Three months after operation, limb static and motor tremor, dysarthria, palate spasm, eye movement disorder and walking difficulty appeared. The patient was diagnosed as HOD according to clinical features and brain magnetic resonance imaging (MRI). He was treated with pertinence rehabilitation training combined with TCM including acupuncture and herbs. After integrative rehabilitation, he could stand and walk independently, the tremor was alleviated, the balance function improved, the activities of daily living improved, and the dosage of oral western medicine also decreased. Conclusion After intracranial surgery, secondary neurodegeneration and movement disorder may appear, and it could be improved by integrative rehabilitation treatment of TCM and Western medicine

Rehabilitation of Hypertrophic Olivary Degeneration Secondary to Pontine Hemorrhage:One Case Report / 中国康复理论与实践

Objective To investigate the clinical and rehabilitation treatment of hypertrophic olivary degeneration(HOD)secondary to brainstem hemorrhage.Methods The clinical data of one patient with HOD secondary to pontine hemorrhage was retrospectively analyzed. In addition to the disability of the primary disease,involuntary jitter of the right limb gradually presented and aggravated.The patient re-ceived physical therapy,occupational therapy,acupuncture,hydrotherapy and medication.Results After one and a half-month rehabilitation and treatment,the patient improved from standing unsteadily and unable to walk to standing and walking independently.The score of Berg Balance Scale improved from 28 to 38,and the score of modified Barthel Index improved from 70 to 80.The involuntary jitter of the right limb was relieved.Conclusion The symptoms and disabilities of HOD secondary to pontine hemorrhage can be relieved by medication and rehabilitation,and the activities of daily living can be improved.

Clinical and Imaging Features of Hypertrophic Olivary Degeneration Secondary to Brainstem Hemorrhage：1 Case Report / 中国康复理论与实践

Objective To investigate the clinical and imaging features of hypertrophic olivary degeneration (HOD) secondary to brain-stem hemorrhage. Methods The clinical data of one patient with HOD secondary to brainstem hemorrhage was retrospectively analyzed. Re-sults The patient was hospitalized with paroxysmal and body involuntary jitter and other extrapyramidal symptoms. After admission, MRI scan showed bilateral inferior olive nucleus of medulla oblongata were localized hypertrophy. Conclusion The main clinical manifestation of HOD secondary to brainstem hemorrhage is extrapyramidal symptom. The imaging features are abnormal signals and localized hypertro-phy at inferior olive nucleus.

Bilateral Hypertrophic Olivary Degeneration in Wilson Disease

Hypertrophic olivary degeneration resulting from lesions of the dento-rubro-olivary pathway, also called Guillain-Mollaret-triangle, has been described previously in a number of cases. Reports about bilateral hypertrophic olivary degeneration of the inferior olivary nuclei are very limited, and the magnetic resonance imaging findings of hypertrophic olivary degeneration in Wilson disease have not yet been described to the best of our knowledge. Herein, we present the first report of bilateral hypertrophic olivary degeneration diagnosed by magnetic resonance imaging in a patient suffering from Wilson disease.

Clinical manifestations and MR imaging characteristics of hypertrophic olivary degeneration / 中华神经医学杂志

Objective To analyze the clinical manifestations and MRI characteristics of hypertrophic olivary degeneration (HOD) to improve our knowledge for this disease and reduce misdiagnosis.Methods Twelve patients with HOD,admitted to our hospital from 2009 to 2012,were chosen in our study; their clinical data,including onset age,protopathy and other clinical manifestations,and imaging data,including SE sequence axial T1WI,T2WI and FLAIR fast spin-echo imaging,were analyzed.Results The protopathy in these 12 patients included pontine hemorrhage in 5,cerebellar infarction in 3,cerebral hemorrhage in 2,midbrain infarction in 1 and surgery for cerebellar tumor in 1.The main clinical symptoms included palatal myoclonus in 7,ataxia in 6,ocular myoclonus in 5,glossolalia in 3,diplopia in 2 and extremity tremor in 2.The region of inferior olivary nucleus (ION)presented high intensity on T2WI and iso-or mild hypointensity on T1WI in all 12 patients.Bilateral ION showed high signals in 5 in FLAIR; enlargement of the ION in 11 patients were noted.Conclusions HOD is a pathological phenomenon that occurs after injury to the dentato-olivary pathway.Its hallmarks include hypertrophy of the olive with increased T2 signal intensity on magnetic resonance imaging,and it often manifests with oculopalatal myoclonus clinically.

Degeneração olivar hipertrófica após ressecção de metástase cerebelar: relato de caso e revisão da literatura / Hypertrophic olivary degeneration secondary to resection of cerebellar metastasis: case report and literature review

Degeneração olivar hipertrófica resulta de lesão no circuito formado pelos núcleos denteado, rubro e olivar inferior (triângulo de Guillain e Mollaret). Pode ser secundária a hemorragias, trauma, neoplasias, entre outras causas que lesem estruturas desse circuito. Destaca-se a relevância deste relato de caso por apresentar um caso de degeneração olivar hipertrófica bilateral, secundária a insulto em ambos os núcleos denteados após ressecção de metástase.

Hypertrophic olivary degeneration represents the results of a lesionthat damages the neuronal connections between the dentate nucleus of the cerebellum, the red nucleus, and the inferior olivary nucleus (Guillain Mollaret triangle). This entity can occur secondary to hemorrhage, trauma, neoplasm and other causes that candamage structures of this pathway. This is an important case report because of its description of a bilateral hypertrophic olivary degeneration, secondary to injuries in both dentate nucleous after metastatic resection.

Bilateral Hypertrophic Olivary Degeneration with Oculopalatal Tremor after Brainstem Hemorrhage: A case report

Hypertrophic olivary degeneration is a form of transynaptic degeneration, which is caused by a lesion in the dentate-rubro-olivary pathway. Commonly described lesions were brainstem stroke, neoplasm, demyelination, and trauma. It's clinical presentations are Holmes tremor, and palatal tremor. This case was a 49-year-old man who was diagnosed as bilateral brainstem hemorrhage. About 2 months later, he had developed bilateral Holmes tremor of upper extremities and oculopalatal termor. Brain MRI was performed at 13 months after onset. MRI showed hyperintense and hypertrophied lesion on T2-weighted image in both inferior olivary nuclei.

Hemiplegia and Palatal Myoclonus after Hypertrophic Olivary Degeneration: A case report

Hypertrophic olivary degeneration (HOD) is caused by the damage of dentator rubroolivary pathway which triangular area is consisted of red nucleus, dentate nucleus, inferior olivary nucleus and the connection fibers. It usually resulted from vascular damage in pons or cerebellum, and also fromencephalitis, degenerative disease, multiple sclerosis, tumor and trauma. We experienced this case of a 56-year-old man with characteristic clinical findings of HOD such as palatal myoclonus, ipsilesional facial palsy, crossed hemiplegia and truncal ataxia after right pons and midbrainhemorrhage. Therefore we report this case with observation of olivary nucleus size in brain MRI followed up after 5 years.

Post-traumatic Hypertrophic Olivary Degeneration: A case report

Hypertrophic olivary degeneration is usually caused by a lesion in the triangle of Guillain and Mollaret. The inciting pathology includes ischemic, inflammatory, degenerative or, less frequently, traumatic lesions. Clinically, it is usually accompanied by palatal myoclonus or other forms of segmental myoclonus. We present four patients with hypertrophic olivary degeneration studied with MRI after severe head trauma. MRI was performed between 5 and 18 months respectively after trauma. Although post-traumatic tremor was observed in three patients, none of patients showed palatal myoclonus. MRI showed multiple post-traumatic lesions within the dentato-rubro-olivary pathway associated with enlargement and increased signal intensity of the inferior olives.