Post-traumatic hypertrophic olivary degeneration associated with Holmes tremor: clinical-imaging correlation
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Abstract
Hypertrophic olivary degeneration is a disease secondary to damage to the neuronal circuit of the Guillain Mollaret Triangle, generating symptoms as varied as Holmes tremor. This article describes the case of a 52-year-old man, with a history of head trauma in 2016, without mediate sequelae, who progressively presented tremor, associated 5 years later with headache requiring emergency assistance, where studies were carried out and pharmacological therapy was instituted. Finally, it is concluded that post-traumatic lesions in the Guillain Mollaret Triangle can generate movement disorders secondary to hypertrophic olivary degeneration as sequelae, an entity that is rarely diagnosed.
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References
Font R, Ramos J, Torales O, Moreno S, Bondía J, Martí M. Degeneración olivar hipertrófica: formas de presentación en resonancia magnética. Seram. 2021;1(1): 1-21.
Murdoch S, Shah P, Jampana R. The Guillain–Mollaret triangle in action. Pract Neurol. 2016;16(3):243-246. https://doi.org/10.1136/practneurol-2015-001142
Behzadi F, Fiester PJ, Rao D. Bilateral Hypertrophic Olivary Degeneration Following Brainstem Insult: A Retrospective Review and Examination of Causative Pathology. Neurosci Insights. 2021;16. https://doi.org/10.1177/26331055211007445
Wang H, Wang Y, Wang R, Li Y, Wang P, Li J, et al. Hypertrophic olivary degeneration: A comprehensive review focusing on etiology. Brain Res. 2019; 1718:53-63. https://doi.org/10.1016/j.brainres.2019.04.024
Dogan SN. Hypertrophic Olivary Degeneration and Holmes Tremor: Case Report and Review of the Literature. World Neurosurg. 2020; 137:286-290. https://doi.org/10.1016/j.wneu.2020.02.068
Demaerel R, Demaerel P, van Loon J, Decramer T. Limb ataxia after double hit in the Guillain–Mollaret triangle. Acta Neurol Belg. 2020;120(3):771-773. https://doi.org/10.1007/s13760-020-01313-6
Fleet JL, Calver R, Perera GC, Deng Z. Palato-pharyngo-laryngeal myoclonus with recurrent retrograde feeding tube migration after cerebellar hemorrhagic stroke: A case report and review of hypertrophic olivary degeneration. BMC Neurol. 2020;20(1):1-5. https://doi.org/10.1186/s12883-020-01800-6
Wang YL, Gao Y, He PP, Yin J, Dong R, Li X, et al. A meta-analysis of case studies and clinical characteristics of hypertrophic olivary degeneration secondary to brainstem infarction. J Integr Neurosci. 2020;19(3):507-511. https://doi.org/10.31083/j.jin.2020.03.1238
Lycett M, Cui CK, Dragicevich D, Harris R, Ng K. Hypertrophic olivary degeneration associated with bilateral vocal cord adductor dystonia. BMC Neurology 2023 23:1. 2023;23(1):1-4. https://doi.org/10.1186/s12883-023-03123-8
Bulleid L, Hughes T, Leach P. Mollaret’s triangle: An important neuroanatomical territory for all clinicians. Surgical Neurology International. 2021;12(94): 1-3. https://doi.org/10.25259/SNI_625_2020
Zhou J, Liu Y, Ali Shah SZ. Hypertrophic olivary degeneration following cerebral trauma managed with rehabilitation — A case report. J Pak Med Assoc. 2021;71(4):1252-1254. https://doi.org/10.47391/JPMA.1124
Schaller MA, Steidl E, Shrestha M, Deichmann R, Steinmetz H, Seiler A, et al. Multicenter Prospective Analysis of Hypertrophic Olivary Degeneration Following Infratentorial Stroke (HOD-IS): Evaluation of Disease Epidemiology, Clinical Presentation, and MR-Imaging Aspects. Front Neurol. 2021; 12:1124. https://doi.org/10.3389/fneur.2021.675123
Steidl E, Rauch M, Hattingen E, Breuer S, Rudiger J, Grapengeter M, et al. Qualitative and quantitative detectability of hypertrophic olivary degeneration in T2, FLAIR, PD, and DTI: A prospective MRI study. Front Neurol. 2022;13: 950191. https://doi.org/10.3389/fneur.2022.950191
Onen MR, Moore K, Cikla U, Ucer M, Schmidt B, Field A, et al. Hypertrophic Olivary Degeneration: Neurosurgical Perspective and Literature Review. World Neurosurg. 2018;112: e763-e771. https://doi.org/10.1016/j.wneu.2018.01.150
Elnekiedy A, Naguib N, Hamed W, Mekky J, Mamdouh Hassan HH. MRI and neurological presentation of hypertrophic olivary degeneration. Egyptian Journal of Radiology and Nuclear Medicine. 2016;47(3):1019-1029. https://doi.org/10.1016/j.ejrnm.2016.04.019
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. https://doi.org/10.12998/wjcc.v10.i1.289
De Lima Raeder MT, Reis EP, Campos BM, Zamilute IAG, Junior MCF, Reis F. Transaxonal degenerations of cerebellar connections: the value of anatomical knowledge. Arq Neuropsiquiatr. 2020;78(5):301-306. https://doi.org/10.1590/0004-282x20200021
Radu RA, Ionita LM, Terecoasa EO, Marinescu AN, Tiu C. Hypertrophic olivary degeneration after brainstem haemorrhage – A case report. Romanian Journal of Neurology/ Revista Romana de Neurologie. 2019;18(1):45-50. https://doi.org/10.37897/RJN.2019.1.8
Kakei S, Manto M, Tanaka H, Mitoma H. Pathophysiology of Cerebellar Tremor: The Forward Model-Related Tremor and the Inferior Olive Oscillation-Related Tremor. Front Neurol. 2021; 12:954. https://doi.org/10.3389/fneur.2021.694653
Özdemir M, Turan A, Pelin R, Dilli A. Hypertrophic olivary degeneration: A case report. Indian J Radiol Imaging. 2019; 29:435-437. https://doi.org/10.4103/ijri.IJRI_412_18
Cosentino C, Velez M, Nuñez Y, Palomino H, Quispe D, Flores M, et al. Bilateral Hypertrophic Olivary Degeneration and Holmes Tremor without Palatal Tremor: An Unusual Association. Tremor and Other Hyperkinetic Movements. 2016; 6:400. https://doi.org/10.5334/tohm.302
Ogut E, Armagan K, Tufekci D. The Guillain-Mollaret triangle: a key player in motor coordination and control with implications for neurological disorders. Neurosurgical Review. 2023; 46:181. https://doi.org/10.1007/s10143-023-02086-1
Bhatia KP, Bain P, Bajaj N, Elble RJ, Hallet M, Louis ED, et al. Consensus Statement on the classification of tremors. from the task force on tremor of the International Parkinson and Movement Disorder Society. Movement Disorders. 2018;33(1):75-87. https://doi.org/10.1002/mds.27121
Pyrgelis ES, Agapiou E, Angelopoulou E. Holmes tremor: an updated review. Neurological Sciences. 2022;43(12):6731-6740. https://doi.org/10.1007/s10072-022-06352-w