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J Korean Soc Emerg Med > Volume 18(4); 2007 > Article
Journal of The Korean Society of Emergency Medicine 2007;18(4): 355-358.
Ondine's Curse in a Patient with Right Medullary and Bilateral Cerebellar Infarctions: A Case Report
Joo Hyun Suh, Eun Kyung Eo
1Department of Internal Medicine, Gachon University of Medicine and Science, Korea.
2Department of Emergency Medicine, School of Medicine, Ewha Womans University, Korea. liz0803@ewha.ac.kr
Failure of automatic control of ventilation (Ondine's curse syndrome) is a rare syndrome that sometimes occurs following localized brainstem dysfunction. In this report, we present a case of a 52-year-old male who was admitted to the hospital with sudden-onset nausea. On examination, no lateralization signs were presented. After one hour, his consciousness was altered and he became apneic. After endotracheal intubation and mechanical ventilation, his mentality improved and he was able to ventilate spontaneously. Cranial magnetic resonance imaging demonstrated acute infarction in both cerebellar inferior aspects involving the right side of the medulla. Eleven hours later, the patient's consciousness altered again. Computed tomography demonstrated newly developed hydrocephalus and emergent craniotomy, and extraventricular drainage were performed. The patient improved in both consciousness and respiratory status but complained of mild ataxia and left arm weakness. We recommend cautious examination and early diagnosis and therapeutic decisions in cases of patients with atypical presentation of stroke.
Key words: Central sleep apnea, Posterior circulation brain infarction, Brainstem infarction, Hydrocephalus
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