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Published on: December 13, 2017
Deterioration of palatal myoclonus after acute thalamic hemorrhage
Chun-Jie Guo1, Kai Niu2, Yu-Dan Lv3
1Department of Radiology, The First Hospital of Jilin University, Xinmin St. 71, 130021 Changchun, P. R. China.
Background:
Palatal myoclonus (PM) is the hallmark of hypertrophic olivary degeneration (HOD); however, little is known regarding the association of thalamic lesions and PM. Case presentation: Here, we report a case of deteriorative PM after an acute small ventrolateral thalamic hemorrhage in a female Chinese patient with HOD. The sudden and severe deterioration of PM was preceded by at least 10 days of an occasionally occurring PM, which was related to an acute cerebellar hemorrhage 8 months earlier. A computed tomography scan upon admission showed a small intracerebral hematoma in the left ventrolateral thalamus, and a magnetic resonance imaging scan revealed the typical signs of HOD as well as a remote lesion in the dentate nucleus. Symptoms of PM were controlled by carbamazepine and clonazepam.
Conclusion:
These findings indicated that the damaged dentatothalamic tract might be due to a unique pathogenic mechanism involving a lesion of the ventrolateral thalamus and Guillain-Mollaret triangle.
Insights
Palatal myoclonus (PM) worsened after a thalamic hemorrhage in a patient with hypertrophic olivary degeneration (HOD). This suggests a link between ventrolateral thalamic lesions and PM, potentially involving the dentatothalamic tract.
Area of Science:
- Neurology
- Neuroscience
- Medical Case Study
Background:
- Palatal myoclonus (PM) is typically associated with hypertrophic olivary degeneration (HOD).
- The relationship between thalamic lesions and PM is not well understood.
- This case examines PM deterioration following a ventrolateral thalamic hemorrhage in a patient with HOD.
Observation:
- A case of a female Chinese patient with HOD experienced sudden, severe PM deterioration.
- This followed an acute small ventrolateral thalamic hemorrhage, preceded by occasional PM linked to an earlier cerebellar hemorrhage.
Findings:
- Imaging revealed a left ventrolateral thalamic hematoma and signs of HOD with a remote dentate nucleus lesion.
- Symptoms of PM were managed with carbamazepine and clonazepam.
Implications:
- The damaged dentatothalamic tract may result from a unique pathogenic mechanism.
- This involves ventrolateral thalamic lesions and the Guillain-Mollaret triangle, offering new insights into PM.
