Olivary hypertrophy: histochemical demonstration of hydrolytic enzymes

Of four patients with palatal myoclonus, three had infarcts resulting from atherosclerosis, and one had cerebral emboli from a left atrial myxoma. Three specimens showed lesions in the brainstem and bilateral hypertrophy of the inferior olivary nuclei; the fourth revealed unilateral olivary changes caused by an infarct in the contralateral dentate nucleus. After incubation for acetylcholinesterase, neuropilar and capillary wall staining were absent or much reduced, but there was increased denisty of reaction product in the neuronal cell bodies and in numerous tortuous dendrites. Methods for acid phosphatase showed strong activity in the dendrites and glomeruloid structures of the diseased olives. Reactions for nonspecific esterase indicated dendritic expansion and reduced staining density in nerve cell bodies, but augmented glial reactivity.