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.