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IMR Press / JIN / Volume 19 / Issue 3 / DOI: 10.31083/j.jin.2020.03.1238
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A meta-analysis of case studies and clinical characteristics of hypertrophic olivary degeneration secondary to brainstem infarction
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1 Department of Neurology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, P. R. China
*Correspondence: hongzhang@cmu.edu.cn (Hong Zhang)
J. Integr. Neurosci. 2020, 19(3), 507–511; https://doi.org/10.31083/j.jin.2020.03.1238
Submitted: 15 November 2019 | Revised: 17 April 2020 | Accepted: 24 April 2020 | Published: 30 September 2020
(This article belongs to the Special Issue Exploration of mechanisms in cortical plasticity)
This is an open access article under the CC BY-NC 4.0 license (https://creativecommons.org/licenses/by-nc/4.0/).
Abstract

Transsynaptic degeneration in the cerebellum and brainstem may give rise to a rare neurological condition with various clinical manifestations, namely hypertrophic olivary degeneration. The classical manifestations of hypertrophic olivary degeneration comprise myoclonus, palatal tremor, ataxia, and ocular symptoms. Any lesions interrupting the dentate-rubro-olivary pathway, referred to as the anatomic Guillain-Mollaret triangle, contribute to the broad aetiologies of hypertrophic olivary degeneration. The clinical diagnosis depends primarily on the associated symptoms and the characteristic magnetic resonance imaging findings. Concerning treatment and prognosis, there are no widely accepted guidelines. Here, we identified 11 cases of hypertrophic olivary degeneration secondary to brainstem infarction from 1964 to the present. Combined with two of our cases, the clinical and imaging findings of 13 patients with hypertrophic olivary degeneration secondary to brainstem infarction were studied. A meta-analysis of case studies gives the correlation coefficient between infraction location and time to develop hypertrophic olivary degeneration as 0.217 (P = 0.393, P $>$ 0.05). At the significance level of P $<$ 0.05, there was no significant correlation between infraction location and time to develop hypertrophic olivary degeneration. The $\chi{}^{2}$ between infraction location and magnetic resonance imaging findings of hypertrophic olivary degeneration was 8.750 (P = 0.364, P $>$ 0.05). At the significance level of P $<$ 0.05, there was no significant correlation between infraction location and magnetic resonance imaging findings of hypertrophic olivary degeneration. Conclusion based on the analysis of available data suggests that when newly developed or progressive worsening motor symptoms are presented in patients with previous brainstem infarction, a diagnosis of hypertrophic olivary degeneration should be investigated.

Keywords
Hypertrophic olivary degeneration
brainstem
Guillain-Mollaret triangle
inferior olive nucleus
magnetic resonance imaging
neurological dysfunction
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