Teaching NeuroImages: Ondine curse syndrome caused by dorsolateral medullary stroke

Fiedler, Erin; Gill, Rick

doi:10.1212/wnl.0000000000009219

Cited by 3 publications

(2 citation statements)

References 1 publication

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“…Unilateral medullary infarction could lead to Ondine's curse featuring cessation of automatic respiration, while voluntary respiration is preserved 1,5 . This case report demonstrated that a unilateral medullary infarction could induce Ondine's curse because of the impairment of automatic respiration and complete absence of the ipsilateral respiratory movement.…”

Section: Discussionmentioning

confidence: 71%

Respiratory movement in Ondine’s curse after unilateral medullary infarction: A case report

Hirayama

Tateishi

Kanamoto

et al. 2020

Neurology & Clinical Neurosc

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Ondine's curse secondary to unilateral medullary infarction has been reported. However, the mechanism remains unclear. This case of a patient with an infarction extending from the right side of the medulla oblongata to the spinal cord at the C1 level showed absence and decrease of respiratory movement on the right and left sides of the chest, respectively, during automatic respiration. The physiological respiratory findings implied that Ondine's curse due to unilateral medullary infarction could be caused by both the impaired regulation of automatic respiration and the disconnection of the projection to ipsilateral phrenic motoneurons.

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Section: Discussionmentioning

confidence: 71%

Respiratory movement in Ondine’s curse after unilateral medullary infarction: A case report

Hirayama

Tateishi

Kanamoto

et al. 2020

Neurology & Clinical Neurosc

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“…Gofton et al (7) reported a case of medullary dorsolateral syndrome combined with severe bradycardia and ataxia that has similarities to the present case. In addition, lateral medullary syndrome can also present with autonomic respiratory arrest due to damage to the decussating medullary and spinal pathways and consequent central hypoventilation syndrome or "Ondine's curse" (8). In the clinic, close ECG monitoring of patients with lateral medullary syndrome should be conducted for early detection of severe arrhythmias, cardiac arrest, respiratory arrest, and other adverse events, and early intervention should be practiced to reduce the possibility of sudden death.…”

Section: Discussionmentioning

confidence: 99%

Vertebral artery dissection induced lateral medullary syndrome characterized with severe bradycardia: a case report and review of the literature

Sun¹,

Ye²,

Ye³

et al. 2022

Ann Palliat Med

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Background: Lateral medullary syndrome is the most common type of brainstem infarction. Lateral medullary syndrome results in damage to the corresponding cranial nerve nuclei and the nucleus tractus solitarius, with vertigo, ipsilateral ataxia, crossed sensory disturbances, Horner's sign, bulbar palsy, and other underlying symptoms or signs. However, cases with cardiac arrhythmia and other autonomic dysfunctions as the primary manifestations are less common. Clinically, sudden death occasionally occurs in patients with lateral medullary syndrome, which may be associated with severe cardiac arrhythmia. These patients may suffer in life-threatening arrhythmia and even cardiac arrest, and vital signs should be closely monitored to prevent sudden death. In younger patients, vertebral artery dissection is the most common cause.Case Description: Here, we present a case of lateral medullary syndrome caused by vertebral artery dissection with severe bradycardia. The patient was a 49-year-old man who was admitted with "sudden onset of numbness in the left limbs and right side of the face for 1 hour". Electrocardiogram (ECG) monitoring showed a repeated heart rate decrease to as low as 23 beats/min, followed by a gradual increase in heart rate to 35-55 beats/min after 2-3 seconds. Head magnetic resonance imaging (MRI) examination revealed right dorsolateral cerebral infarction of the medulla oblongata. Digital subtraction angiography (DSA) revealed a right vertebral artery dissecting aneurysm. We performed an emergency placement of a temporary pacemaker, followed by conservative treatment with platelet aggregation inhibitors, vascular softening agents and improved collateral circulation. Elective spring coil embolization of the vertebral artery dissecting aneurysm and stent implantation were performed. At outpatient follow-up, the patient had a good prognosis.Conclusions: Clinical management of patients with lateral medullary syndrome should be prioritized, with close cardiac monitoring at the early stages of observation and pacemaker placement and tracheal intubation as required to prevent adverse events.

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COVID-19: a new emerging respiratory disease from the neurological perspective

El-Sayed

Aleya

Kamel

2021

Environ Sci Pollut Res

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Coronavirus disease 2019 (COVID-19) has become a challenging public health catastrophe worldwide. The newly emerged disease spread in almost all countries and infected 100 million persons worldwide. The infection is not limited to the respiratory system but involves various body systems and may lead to multiple organ failure. Tissue degenerative changes result from direct viral invasion, indirect consequences, or through an uncontrolled immune response. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreads to the brain via hematogenous and neural routes accompanied with dysfunction of the blood–brain barrier. The involvement of the central nervous system is now suspected to be among the main causes of death. The present review discusses the historical background of coronaviruses, their role in previous and ongoing pandemics, the way they escape the immune system, why they are able to spread despite all undertaken measures, in addition to the neurological manifestations, long-term consequences of the disease, and various routes of viral introduction to the CNS.

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Teaching NeuroImages: Ondine curse syndrome caused by dorsolateral medullary stroke

Cited by 3 publications

References 1 publication

Respiratory movement in Ondine’s curse after unilateral medullary infarction: A case report

Respiratory movement in Ondine’s curse after unilateral medullary infarction: A case report

Vertebral artery dissection induced lateral medullary syndrome characterized with severe bradycardia: a case report and review of the literature

COVID-19: a new emerging respiratory disease from the neurological perspective

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