Cover Image

A Rare Case Of Bilateral hypertrophic olivary degeneration



Hypertrophic olivary degeneration is a result of a primary lesion damaging the dentorubro- olivary pathway. Causes include primary lesions in contralateral dentate nucleus or ipsilateral central tegmental tract, focal brain stem insults  leading to dentatorubral-olivary pathway  disruption. Ischemia, demyelination, Hemorrhage,   cerebrovascular malformation, or diffuse axonal injury following severe head trauma are most common causes for this  degeneration. It is a transynaptic form of degeneration and unique, causing hypertrophy rather than atrophy of the inferior olivary nucleus. Progressive ataxia and palatal tremor(PAPT) is a rare distinct clinical entity characterized by symptomatic   palatal tremor associated with progressive ataxia.Only few cases have been described in literature, and MRI findings show, in most cases, cerebellar atrophy and unilateral inferior olivary hypertrophy . We report a case where MRI study at 1.5T  demonstrated marked bilateral olivary complex hyperintensity and hypertrophy and marked cerebellar atrophy.


Full Text:




Kim SJ, Lee JH, Suh DC. Cerebellar MR changes in patients with olivary hypertrophic degeneration. AJNR Am J Neuroradiol. 1994; 15: 1715- 1719.

Gerace C, Fele MR, Luna R, Piazza G. Neurological picture. Bilateral hypertrophic olivary degeneration. J Neurol Neurosurg Psychiatry. 2006; 77: 73.

Suzuki M, Takashima T, Ueda F, Fujinaga Y, Horichi Y, Yamashita J. Olivary degeneration after intracranial haemorrhage or trauma: follow-up MRI. Neuroradiology. 1999; 41: 9-12.

Hornyak M, Osborn AG, Couldwell WT. Hypertrophic olivary degeneration after surgical removal of cavernous malformations of the brain stem: report of four cases and review of the literature. Acta Neurochir (Wien). 2008; 150: 149-156.

Sanverdi S, Oguz K, Haliloglu G. Hypertrophic Olivary Degeneration in Children: new 4 cases and review of literature with emphasis on the MR imaging findings. The British Journal of Radiology. 85 (2012), 511-16.

Dinçer A, Özyurt O, Kaya D, Koak E, Öztürk C, Erzen C, et al. Diffusion tensor imaging of Guillain- Mollaret triangle in patients with hypertrophic olivary degeneration. J Neuroimaging. 2011; 21: 145- 151.

Chen X, Weigel D, Ganslandt O, Buchfelder M, Nimsky C. Diffusion tensor imaging and white matter tractography in patients with brainstem lesions. Acta Neurochir (Wien). 2007; 149: 1117-1131.

Goto N, Kakimi S, Kaneko M. Olivary enlargement: stage of initial astrocytic changes. Clin Neuropathol. 1988; 7: 39-43.


  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

An Initiative of The Tamil Nadu Dr M.G.R. Medical University