Objective: . Clinical practice often confronts us with ambiguous and conflicting data from the “western” and “eastern” publications, which leads to misunderstandings and disagreements, so we set out to bring on a common state dilemma of contradiction in respect of hereditary ataxia.

Background: Background and objectives. Modern scientific literature is growing rapidly as the jungle, where many secrets and rare treasures are hidden. The trend of development of medicine requires a doctor’s daily analysis and processing of a dozen of new articles and abstracts.

Methods:  A 54 years old man, an accountant, admitted to our clinic, with a diagnosis of “Essential hypertension, Chronic brain ischemia, Sensorineural hearing loss, Organic amnestic syndrome “, with complaints of tinnitus, which progressively grew last 5 years and has led to hearing loss. The disease began with low intensity noise, which grew over the last 5 years. No harmful habits were detected. No family history. After detailed examination we revealed saccadic pursuit, violation of postural reflexes, retropulsion, light spasticity in the legs, swallowing disorders, dysarthria. Audiometry – sensorineural hearing loss (3-4 degree) with violation of the perception of high frequency sounds. MRI – MR signs of vascular encephalopathy

Results:  Our analysis showed that, in our patient more accurate diagnosis is spinocerebellar ataxia type 36, however, olivopontocerebellar atrophy with its 5 subtypes to date are included in spinocerebellar ataxia taxonomy and multiple system atrophy, in addition olivopontocerebellar atrophy is observed in many other diseases: non-hereditary ataxia, intoxication and vascular degeneration

Conclusions: Proceeding from the above, it is clear that the diagnosis of olivopontocerebellar atrophy is in the most syndromic, and requires a doctor’s deeper view into patient’s progressive ataxia. The question of necessity in verification of exact diagnosis remains open, as in bears no tactical value. But, tracking such cases and the description of them is preserved in science as one the most relevant methods for the studying of rare diseases. In our opinion the doctor should solve clinical problem of “multidiseased” patient under guidance of Occam’s razor principals, one of which states – “Diversity should not be assumed without necessity.”

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-diagnostic-dilemma-of-olivopontocerebellar-atrophy-and-spinocerebellar-ataxia-a-comparative-analysis-of-clinical-cases/