LAUSR

Annals of Indian Academy of Neurology ¦ Volume 25 ¦ Issue 3 ¦ May-June 2022 567 being delayed onset after stroke. The compensatory mechanisms or secondary changes in the central nervous system such as brain plasticity have been accused; however, the mechanisms processing from the insult to the occurrence of tremor are poorly understood.[4] Remarkably, the radiological appearance of inferior olivary degeneration is often seen several months after the original insult as well.[1] The clinical presentation and the serial imaging data of our patient present a smart clinicoradiological illustration of hypertrophic olivary degeneration. The MRI, performed one month after the event, shows a normal appearance of the inferior olivary nucleus. However, the MRI, performed at admission due to newly emerging tremor, 10 months after stroke, shows the development of the hypertrophic inferior olivary nucleus. The final MRI, four months after, still showed the persistence of the abnormal signal of the Olivary nucleus. The results of the future prospective studies of a larger number of patients may also provide substantial contributions in this regard. The clinicians should be aware of this radiological appearance while performing the differential diagnosis and the palatal myoclonus should be kept in mind as a pathognomonic finding of this entity.[1,8]