Long-standing myoclonic hand tremor as an isolated symptom of hypertrophic olivary degeneration

Sławomir Budrewicz; Magdalena Koszewicz; Paulina Konieczna; Anna Zimny

doi:10.1016/j.clineuro.2023.107871

Long-standing myoclonic hand tremor as an isolated symptom of hypertrophic olivary degeneration

Clin Neurol Neurosurg. 2023 Sep:232:107871. doi: 10.1016/j.clineuro.2023.107871. Epub 2023 Jul 3.

Authors

Sławomir Budrewicz¹, Magdalena Koszewicz², Paulina Konieczna³, Anna Zimny⁴

Affiliations

¹ Department of Neurology, Wroclaw Medical University, Wroclaw, Poland. Electronic address: slawomir.budrewicz@umw.edu.pl.
² Department of Neurology, Wroclaw Medical University, Wroclaw, Poland. Electronic address: magdalena.koszewicz@umw.edu.pl.
³ Department of Neurology, Wroclaw Medical University, Wroclaw, Poland. Electronic address: paulina.konieczna@umw.edu.pl.
⁴ Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical, University, Wroclaw, Poland. Electronic address: anna.zimny@umw.edu.pl.

PMID: 37413873
DOI: 10.1016/j.clineuro.2023.107871

Abstract

Hypertrophic olivary degeneration (HOD) is a rare condition caused by lesions of the dentato-rubro-olivary pathway, usually bilateral. We presented a case of a 64-year old male with HOD caused by a unilateral, posterior pontine cavernoma. The patient has not developed the typical palate myoclonus until recently. Isolated hand myoclonus with coexisting asterixis was present for years. This case shows unique HOD symptomatology and emphasizes the important role of MRI in the differential diagnosis of monomelic myoclonus.

Keywords: Brainstem cavernoma; Holmes tremor; Hypertrophic olivary degeneration; Myoclonic tremor; Tractography.

Publication types

Case Reports

MeSH terms

Humans
Hypertrophy / pathology
Magnetic Resonance Imaging / adverse effects
Male
Middle Aged
Myoclonus* / etiology
Nerve Degeneration / pathology
Olivary Nucleus* / pathology
Pons / pathology
Tremor / complications