scholarly journals Bilateral Hypertrophic Olivary Degeneration and Holmes Tremor without Palatal Tremor: An Unusual Association

2016 ◽  
Vol 6 (0) ◽  
pp. 400 ◽  
Author(s):  
Carlos Cosentino ◽  
Miriam Velez ◽  
Yesenia Nuñez ◽  
Henry Palomino ◽  
Darko Quispe ◽  
...  
Keyword(s):  
Hypertrophic Olivary Degeneration ◽  
Palatal Tremor ◽  
Unusual Association ◽  
Holmes Tremor

scholarly journals Holmes tremor in association with bilateral hypertrophic olivary degeneration and palatal tremor: chronological considerations. Case report

2003 ◽  
Vol 61 (2B) ◽  
pp. 473-477 ◽  
Author(s):  
Carlos R.M. Rieder ◽  
Ricardo Gurgel Rebouças ◽  
Marcelo Paglioli Ferreira
Keyword(s):  
Neuronal Degeneration ◽  
High Signal ◽  
Proton Density ◽  
Rare Type ◽  
Hypertrophic Olivary Degeneration ◽  
Palatal Tremor ◽  
Holmes Tremor ◽  
Nervous System Function ◽  
Uncommon Condition ◽  
Inferior Olivary

Hypertrophic olivary degeneration (HOD) is a rare type of neuronal degeneration involving the dento-rubro-olivary pathway and presents clinically as palatal tremor. We present a 48 year old male patient who developed Holmes' tremor and bilateral HOD five months after brainstem hemorrhage. The severe rest tremor was refractory to pharmacotherapy and botulinum toxin injections, but was markedly reduced after thalamotomy. Magnetic resonance imaging permitted visualization of HOD, which appeared as a characteristic high signal intensity in the inferior olivary nuclei on T2- and proton-density-weighted images. Enlargement of the inferior olivary nuclei was also noted. Palatal tremor was absent in that moment and appears about two months later. The delayed-onset between insult and tremor following structural lesions of the brain suggest that compensatory or secondary changes in nervous system function must contribute to tremor genesis. The literature and imaging findings of this uncommon condition are reviewed.

scholarly journals Multicenter Prospective Analysis of Hypertrophic Olivary Degeneration Following Infratentorial Stroke (HOD-IS): Evaluation of Disease Epidemiology, Clinical Presentation, and MR-Imaging Aspects

2021 ◽  
Vol 12 ◽  
Author(s):  
Martin A. Schaller-Paule ◽  
Eike Steidl ◽  
Manoj Shrestha ◽  
Ralf Deichmann ◽  
Helmuth Steinmetz ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Clinical Symptoms ◽  
Inferior Olivary Nucleus ◽  
Index Event ◽  
Hypertrophic Olivary Degeneration ◽  
Palatal Tremor ◽  
Prophylactic Measures ◽  
Holmes Tremor ◽  
Dti Tractography ◽  
Tractography Data

Introduction: Ischemic and hemorrhagic strokes in the brainstem and cerebellum with injury to the functional loop of the Guillain-Mollaret triangle (GMT) can trigger a series of events that result in secondary trans-synaptic neurodegeneration of the inferior olivary nucleus. In an unknown percentage of patients, this leads to a condition called hypertrophic olivary degeneration (HOD). Characteristic clinical symptoms of HOD progress slowly over months and consist of a rhythmic palatal tremor, vertical pendular nystagmus, and Holmes tremor of the upper limbs. Diffusion Tensor Imaging (DTI) with tractography is a promising method to identify functional pathway lesions along the cerebello-thalamo-cortical connectivity and to generate a deeper understanding of the HOD pathophysiology. The incidence of HOD development following stroke and the timeline of clinical symptoms have not yet been determined in prospective studies—a prerequisite for the surveillance of patients at risk.Methods and Analysis: Patients with ischemic and hemorrhagic strokes in the brainstem and cerebellum with a topo-anatomical relation to the GMT are recruited within certified stroke units of the Interdisciplinary Neurovascular Network of the Rhine-Main. Matching lesions are identified using a predefined MRI template. Eligible patients are prospectively followed up and present at 4 and 8 months after the index event. During study visits, a clinical neurological examination and brain MRI, including high-resolution T2-, proton-density-weighted imaging, and DTI tractography, are performed. Fiberoptic endoscopic evaluation of swallowing is optional if palatal tremor is encountered.Study Outcomes: The primary endpoint of this prospective clinical multicenter study is to determine the frequency of radiological HOD development in patients with a posterior fossa stroke affecting the GMT at 8 months after the index event. Secondary endpoints are identification of (1) the timeline and relevance of clinical symptoms, (2) lesion localizations more prone to HOD occurrence, and (3) the best MR-imaging regimen for HOD identification. Additionally, (4) DTI tractography data are used to analyze individual pathway lesions. The aim is to contribute to the epidemiological and pathophysiological understanding of HOD and hereby facilitate future research on therapeutic and prophylactic measures.Clinical Trial Registration: HOD-IS is a registered trial at https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00020549.

scholarly journals Vim thalamotomy in a patient with Holmes’ tremor and palatal tremor - Pathophysiological considerations

BMC Neurology ◽  
2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Futaba Maki ◽  
Sumito Sato ◽  
Katsushige Watanabe ◽  
Toshiyuki Yanagisawa ◽  
Yuta Hagiwara ◽  
...  
Keyword(s):  
Palatal Tremor ◽  
Holmes Tremor

scholarly journals Hypertrophic Olivary Degeneration and Holmes’ Tremor Secondary to Bleeding of Cavernous Malformation in the Midbrain

2014 ◽  
Vol 4 (0) ◽  
pp. 264 ◽  
Author(s):  
Djalma F. S. Menéndez ◽  
Rubens G. Cury ◽  
Egberto R. Barbosa ◽  
Manoel J. Teixeira ◽  
Erich T. Fonoff
Keyword(s):  
Cavernous Malformation ◽  
Hypertrophic Olivary Degeneration ◽  
Holmes Tremor
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