J Korean Soc Emerg Med.  2007 Aug;18(4):355-358.

Ondine's Curse in a Patient with Right Medullary and Bilateral Cerebellar Infarctions: A Case Report

• Suh JH
• Eo EK

Abstract

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.

Keyword

Central sleep apnea; Posterior circulation brain infarction; Brainstem infarction; Hydrocephalus

MeSH Terms

Arm
Ataxia
Brain Infarction
Brain Stem
Brain Stem Infarctions
Consciousness
Craniotomy
Drainage
Early Diagnosis
Humans
Hydrocephalus
Infarction*
Intubation, Intratracheal
Magnetic Resonance Imaging
Male
Middle Aged
Nausea
Respiration, Artificial
Sleep Apnea, Central
Stroke
Ventilation