The Turkish Journal of Pediatrics 2020 , Vol 62 , Num 2
Pediatric case of persistent hiccups associated with hypertrophic olivary degeneration
Pınar Arıcan 1 ,Özgür Öztekin 2 ,Dilek Çavuşoğlu 3 ,Sema Bozkaya Yılmaz 1 ,Atilla Ersen 1 ,Nihal Olgaç Dündar 4 ,Pınar Gençpınar 4
1 Departments of Pediatric Neurology, İzmir Tepecik Education and Research Hospital, İzmir, Turkey
2 Departments of Radiology, İzmir Tepecik Education and Research Hospital, İzmir, Turkey
3 Department of Pediatric, Neurology, Afyon Kocatepe University, Afyon, Turkey
4 Department of Pediatric Neurology, İzmir Katip Çelebi University, İzmir, Turkey
DOI : 10.24953/turkjped.2020.02.025 Background. Hypertrophic olivary degeneration (HOD) is a rare degenerative disorder that is thought to occur subsequent to a disruption of the dentate-rubro-olivary pathway.

Case. We report a pediatric case of unilateral HOD presented with persistent hiccups and palatal tremor. Radiological examination of diaphragm was normal considering ultrasound and chest x-ray. On T2WI (weighted images) and Fluid Attenuated Inversion Recovery (FLAIR) images, hyperintense enlargement of the right inferior olivary nucleus was seen. No abnormal enhancement was detected on post-contrast scans and no evidence of restricted diffusion was seen. Susceptibility weighted imaging (SWI) sequences revealed a chronic hemorrhage involving the medulla oblongata and cerebellum. Cranial magnetic resonance imaging (MRI) findings were consistent with unilateral HOD. Palatal tremor and dentate-rubral tremor are frequent presentation of HOD, however to our knowledge persistent hiccups had not yet been reported in children with HOD.

Conclusion. We highlight a pediatric case of unilateral HOD, which presented with persistent hiccups. Awareness of clinical and radiological findings of HOD is important to avoid misinterpretation as a mass lesion, an ischemic event, or a demyelinating disease and provide adequate management. Keywords : children, hiccups, hypertrophic olivary degeneration

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