Teaching NeuroImages: Ondine curse syndrome caused by dorsolateral medullary stroke

Abstract

Listen

Translate article

A 68-year-old man with an acute left dorsolateral medullary infarction (figure) had recurrent episodes of hypercarbic respiratory failure with sleep during hospitalization. While awake, the patient ventilated adequately, but when asleep, the patient developed a severe respiratory acidosis (pH 7.14, pCO2 >107) and became unarousable. He was intubated and his mentation improved rapidly. Eventually, he had a tracheostomy placed and continued to have prolonged apneic episodes with sleep during spontaneous breathing trials. The patient did not have central sleep apnea prior to the stroke.