[A case of apnea attacks due to an unilateral infarction in the right medulla oblongata]

Abstract

We described a patient presenting with apnea attacks due to an unilateral small infarction in the right medulla oblongata. The patient was a 55-year-old man and was referred to our hospital because of severe headache and progressive left hemiparesis. Neurological examinations revealed left hemiparesis and the impairment of pain, touch, temperature and vibration sense in the left side of his body. Position sense was normal. Cranial nerves were intact including the trigeminal nerve. Ataxia was not noted. After an admission, the patient suffered from three episodes of apnea attack of sudden onset followed by cardiac arrest and convulsion. Magnetic resonance imaging demonstrated a clearly circumscribed small oblique lesion situated in the caudal lateral tegmental portion to the rostral ventromedial part of right medulla oblongata . The right vertebral artery was not visualized by magnetic resonance angiography. Serial computed tomography scans failed to identify this small lesion. We conclude that apnea attack in the present patient represents a central type apnea caused by the unilateral damage of the respiratory center in the medulla oblongata.