Hypertrophic olivary degeneration(HOD) is a rare neurological condition resulting from the trans-neuronal damage of the dentatorubral-olivary pathway. It is more commonly seen secondary to ischemia, haemorrhage, tumour, trauma, infection, or any inflammatory condition, though few rare cases of idiopathic nature have been reported. MRI findings may be seen as early as four months after the initial insult, which may later be accompanied by classic symptoms of palatal tremors, dentatorubral tremors, ocular myoclonus, or ataxia. Prior knowledge of this condition is required as it may prevent some misdirected interventions. We aim to discuss the relevant anatomy, various patterns, MRI findings and differential diagnosis of HOD through this case series.
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