Bilateral hypertrophic olivary degeneration caused by unilateral midbrain infarction: A case report

Abstract

Hypertrophic olivary degeneration (HOD) arises from lesions of the dentato-rubro-olivary pathway (Guillain–Mollaret triangle), and bilateral HOD is the rarest. Our patient, a 42-year-old man with bilateral HOD caused by unilateral midbrain infarction, had both increased dizziness and ataxia as the first symptoms. HOD has no effective treatment and is easily misdiagnosed as other diseases in clinical practice. Our case demonstrated unique HOD symptomatology and emphasizes the important role of magnetic resonance imaging in diagnosing HOD. The use of gabapentin relieved nystagmus in our patient and may provide a reference for the future treatment of such patients.