Vestibular Rehabilitation of Patient with Hypertrophic Olivary Degeneration: A Case Report.

Background

Hypertrophic olivary degeneration (HOD) is a rare disorder that typically develops in the weeks to months after a structural brainstem or cerebellar lesion in the Guillain-Mollaret triangle. Clinically, patients with HOD present with palatal myoclonus and nystagmus, which are difficult to treat and rarely resolve.Purpose: The purpose of this case report is to present the results of vestibular and balance assessments of a patient with bilateral HOD before and after vestibular rehabilitation.Study Sample: This case report describes a 43-year-old trucker who presented with dizziness, blurred vision, and balance problems for more than 10 months, accompanied by new-onset tremors and ataxia for more than 6 months. The patient’s characteristic clinical manifestations were palatal myoclonus and nystagmus. Magnetic resonance imaging showed bilateral HOD after an acute pontine hemorrhage. Comprehensive vestibular and balance assessments were performed.

Results

Vestibular and balance assessments demonstrated nystagmus, impaired vestibulo-ocular reflex, optokinetic reflex, and balance function. After 4 months of VR, the patient’s eye symptoms and balance function were improved.

Conclusions

The case presented in this report highlights the rare clinical manifestations of HOD after pontine hemorrhage. Vestibular rehabilitation training may be beneficial for the recovery of patients with HOD.