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Our patient and published Alexander disease cases illustrate that oculopalatal tremor can occur in the absence of hypertrophic olivary degeneration. Therefore, cerebellar maladaptation to any form of olivary damage may be the critical pathophysiology in producing oculopalatal tremor. © The Author(s) 2020.Differential lung ventilation treatment is a mechanical ventilation strategy used for unilateral lung disease or injury. This treatment can be provided to patients who fail to respond to conventional mechanical ventilation to both lungs and is techn