Ondine Curse by Brain Stem Infarction

초록

Respiration is classified as limbic, automatic, reflex and voluntary. Centers in the medulla control automaticrespiration and unilateral lesion in the dorsolateral pontomedulla can result in cessation of automaticrespiration. This is called Ondine’s curse, which is a rare and fatal and which could be caused by brainsteminfarction. Here we presented the patient who had diffculty weaning from ventilator, and was later diagnosedwith Ondine curse. A 79-year-old man was admitted to ICU due to aspiration pneumonia and mental changes and underwentintubation. Two weeks later, he became alert and his lung condition improved. But it was difficult to wean thepatient off ventilator, especially at night. MR scans indicated small acute infarction in right dorsalpontomedullary area. We diagnosed him with ondine curse. The patient refused tracheostomy and triednoninvasive ventilator(NIV) helmet ventilation, which was successful in providing respiration support. Ondine Curse may be considered for the patient who had dfficulty in weaning despite of recovery of mentalstatus. NIV helmets are one of good option for the patients, who do not want to undergo invasive procedure.