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Ondine's curse in a patient with unilateral medullary and bilateral cerebellar infarctions.
J Chin Med Assoc. 2005 Nov; 68(11):531-4.JC

Abstract

Central sleep apnea (CSA), also known as Ondine's curse (OC), is a phenomenon characterized by episodes of repeated apnea during sleep due to disorders of the central nervous system. We report a patient with CSA/OC due to right dorsolateral medullary and bilateral cerebellar infarctions that occurred in the clinical setting of right vertebral artery stenosis. Polysomnography (PSG) showed repeated episodes of absence of nasal cannula flow accompanying cessation of thoracic and abdominal respiratory movements and a decline in blood oxygen saturation. The duration of apnea was as long as 12 seconds. Brain magnetic resonance (MR) images showed acute infarctions involving the right dorsolateral medulla, bilateral cerebellar vermis and paramedian cerebellar hemispheres. MR angiography showed nonvisualization of the right vertebral artery. Transcranial Doppler sonography showed a high resistance flow profile in the right vertebral artery and normal flow patterns in the basilar artery and left vertebral artery. These findings suggest that the medullary and bilateral cerebellar infarcts were caused by stenosis/pseudo-occlusion of the right vertebral artery. Reduced respiratory afferent inputs to the dorsal respiratory group of medullary neurons, the nucleus tractus solitarius and reduced "automatic" components of the respiratory drive may play a role in the development of CSA/OC.

Authors+Show Affiliations

Ho HT
Department of Neurology, Mackay Memorial Hospital, Taipei, Taiwan, ROC.
Thajeb P
No affiliation info available
Lin CC
No affiliation info available

MeSH

Brain InfarctionBrain Stem InfarctionsCerebellumHumansMaleMedulla OblongataMiddle AgedSleep Apnea, Central

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

16323397

Citation

Ho, Hui-Tzu, et al. "Ondine's Curse in a Patient With Unilateral Medullary and Bilateral Cerebellar Infarctions." Journal of the Chinese Medical Association : JCMA, vol. 68, no. 11, 2005, pp. 531-4.
Ho HT, Thajeb P, Lin CC. Ondine's curse in a patient with unilateral medullary and bilateral cerebellar infarctions. J Chin Med Assoc. 2005;68(11):531-4.
Ho, H. T., Thajeb, P., & Lin, C. C. (2005). Ondine's curse in a patient with unilateral medullary and bilateral cerebellar infarctions. Journal of the Chinese Medical Association : JCMA, 68(11), 531-4.
Ho HT, Thajeb P, Lin CC. Ondine's Curse in a Patient With Unilateral Medullary and Bilateral Cerebellar Infarctions. J Chin Med Assoc. 2005;68(11):531-4. PubMed PMID: 16323397.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ondine's curse in a patient with unilateral medullary and bilateral cerebellar infarctions. AU - Ho,Hui-Tzu, AU - Thajeb,Peterus, AU - Lin,Ching-Chi, PY - 2005/12/6/pubmed PY - 2005/12/24/medline PY - 2005/12/6/entrez SP - 531 EP - 4 JF - Journal of the Chinese Medical Association : JCMA JO - J Chin Med Assoc VL - 68 IS - 11 N2 - Central sleep apnea (CSA), also known as Ondine's curse (OC), is a phenomenon characterized by episodes of repeated apnea during sleep due to disorders of the central nervous system. We report a patient with CSA/OC due to right dorsolateral medullary and bilateral cerebellar infarctions that occurred in the clinical setting of right vertebral artery stenosis. Polysomnography (PSG) showed repeated episodes of absence of nasal cannula flow accompanying cessation of thoracic and abdominal respiratory movements and a decline in blood oxygen saturation. The duration of apnea was as long as 12 seconds. Brain magnetic resonance (MR) images showed acute infarctions involving the right dorsolateral medulla, bilateral cerebellar vermis and paramedian cerebellar hemispheres. MR angiography showed nonvisualization of the right vertebral artery. Transcranial Doppler sonography showed a high resistance flow profile in the right vertebral artery and normal flow patterns in the basilar artery and left vertebral artery. These findings suggest that the medullary and bilateral cerebellar infarcts were caused by stenosis/pseudo-occlusion of the right vertebral artery. Reduced respiratory afferent inputs to the dorsal respiratory group of medullary neurons, the nucleus tractus solitarius and reduced "automatic" components of the respiratory drive may play a role in the development of CSA/OC. SN - 1726-4901 UR - https://www.unboundmedicine.com/medline/citation/16323397/Ondine's_curse_in_a_patient_with_unilateral_medullary_and_bilateral_cerebellar_infarctions_ DB - PRIME DP - Unbound Medicine ER -