Ondine's curse: clinical presentation with diaphragmatic pacing and spontaneous respiratory recovery. Illustrative case.

Ondine’s curse central hypoventilation syndrome diaphragmatic pacing posterior fossa skull base surgery

Journal

Journal of neurosurgery. Case lessons
ISSN: 2694-1902
Titre abrégé: J Neurosurg Case Lessons
Pays: United States
ID NLM: 9918227275606676

Informations de publication

Date de publication:
22 May 2023
Historique:
received: 02 01 2023
accepted: 16 02 2023
medline: 23 5 2023
pubmed: 23 5 2023
entrez: 23 5 2023
Statut: epublish

Résumé

The complexity of posterior fossa surgery can often lead to rare complications due to the anatomy involved. Vestibular schwannoma resection is a common pathology in the posterior fossa, often requiring surgical intervention. Given the proximity of this space to the brainstem, cranial nerve VII/VIII complex, and posterior inferior cerebellar artery (PICA), neurovascular complications are not infrequent. A rare vascular complication from this surgical approach is a lateral medullary infarction from injury to the lateral medullary segment of the proximal PICA, leading to central hypoventilation syndrome (CHS). This report presents a unique case of a 51-year-old man who underwent a retrosigmoid craniectomy for resection of a vestibular schwannoma. Following surgery, the patient was unable to be weaned off the ventilator and was noted to become apneic while he slept, a clinical picture consistent with Ondine's curse. This report discusses the anatomical considerations of this surgical corridor leading to this complication and the management of a patient with acquired Ondine's curse and reviews the scarce literature on this uncommon cause of acquired CHS.

Sections du résumé

BACKGROUND BACKGROUND
The complexity of posterior fossa surgery can often lead to rare complications due to the anatomy involved. Vestibular schwannoma resection is a common pathology in the posterior fossa, often requiring surgical intervention. Given the proximity of this space to the brainstem, cranial nerve VII/VIII complex, and posterior inferior cerebellar artery (PICA), neurovascular complications are not infrequent. A rare vascular complication from this surgical approach is a lateral medullary infarction from injury to the lateral medullary segment of the proximal PICA, leading to central hypoventilation syndrome (CHS).
OBSERVATIONS METHODS
This report presents a unique case of a 51-year-old man who underwent a retrosigmoid craniectomy for resection of a vestibular schwannoma. Following surgery, the patient was unable to be weaned off the ventilator and was noted to become apneic while he slept, a clinical picture consistent with Ondine's curse.
LESSONS CONCLUSIONS
This report discusses the anatomical considerations of this surgical corridor leading to this complication and the management of a patient with acquired Ondine's curse and reviews the scarce literature on this uncommon cause of acquired CHS.

Identifiants

pubmed: 37218735
doi: 10.3171/CASE233
pii: CASE233
pmc: PMC10550651
doi:
pii:

Types de publication

Journal Article

Langues

eng

Références

Surgery. 2014 Oct;156(4):776-84
pubmed: 25239317
J Craniofac Surg. 2011 Nov;22(6):2163-7
pubmed: 22075814
J Am Med Assoc. 1951 Sep 1;147(1):30-4
pubmed: 14861012
Intern Med. 2009;48(11):925-30
pubmed: 19483363
Acta Anaesthesiol Scand. 2005 Sep;49(8):1214-7
pubmed: 16095465
Chest. 1993 Jun;103(6):1909-10
pubmed: 8404131
Clin Neurol Neurosurg. 1999 Sep;101(3):196-8
pubmed: 10536907
Sleep Breath. 2023 May;27(2):505-510
pubmed: 35554785
Ann Surg. 1970 Oct;172(4):755-73
pubmed: 5458627
Iran J Otorhinolaryngol. 2015 Jan;27(78):63-7
pubmed: 25745613
J Clin Neurosci. 2006 Apr;13(3):370-3
pubmed: 16546390
World Neurosurg. 2011 Dec;76(6):592.e11-4
pubmed: 22251510
Neurol India. 2009 Mar-Apr;57(2):206-7
pubmed: 19439858
Am J Forensic Med Pathol. 2007 Jun;28(2):141-4
pubmed: 17525565
Arq Neuropsiquiatr. 2004 Jun;62(2B):523-7
pubmed: 15273856
Am J Respir Crit Care Med. 2000 Jun;161(6):2100-6
pubmed: 10852794
Front Pediatr. 2020 Jun 19;8:288
pubmed: 32637385
Am Rev Respir Dis. 1981 Aug;124(2):180-5
pubmed: 6973304
Expert Rev Med Devices. 2005 Sep;2(5):577-85
pubmed: 16293069
Clin Neuropathol. 1996 Mar-Apr;15(2):101-5
pubmed: 8925593
J Child Neurol. 2001 Oct;16(10):767-70
pubmed: 11669353
Chest. 1987 Sep;92(3):567-9
pubmed: 3622038
Clin Neuropathol. 1988 Sep-Oct;7(5):234-7
pubmed: 3208461
Sleep Med Clin. 2014 Mar 1;9(1):105-118
pubmed: 24678286
Respir Physiol Neurobiol. 2009 Nov 30;169(2):200-9
pubmed: 19786125
NMC Case Rep J. 2016 Sep 07;3(4):133-136
pubmed: 28664015
Arch Dis Child. 1994 May;70(5):418-23
pubmed: 8017965
J Clin Sleep Med. 2010 Oct 15;6(5):491-509
pubmed: 20957853
Br J Neurosurg. 2013 Dec;27(6):836-7
pubmed: 23672469
J Clin Epidemiol. 2009 Oct;62(10):1006-12
pubmed: 19631508
Stereotact Funct Neurosurg. 1989;53(4):209-22
pubmed: 2518591
Otolaryngol Head Neck Surg. 2000 Oct;123(4):495-500
pubmed: 11020193

Auteurs

Alexander J Schupper (AJ)

Departments of1Neurological Surgery.

Alex Devarajan (A)

Departments of1Neurological Surgery.

Dong-Seok Lee (DS)

2Thoracic Surgery, and.

Enrique Perez (E)

3Otolaryngology, School of Medicine at Mount Sinai, New York, New York.

Raj K Shrivastava (RK)

Departments of1Neurological Surgery.

Classifications MeSH