CASE REPORT: ACQURIED CENTRAL HYPOVENTILATION SYNDROME IN ADULT AFTER POSTERIOR FOSSA TUMOR RESECTION

Bá Tư Nguyễn, Văn Khâm Vũ, Toàn Thắng Nguyễn

Main Article Content

Abstract

Central hypoventilation syndrome (CHS) due to PHOX2B gene mutations in newborns causes a loss of automatic respiration. This condition is very rare in adults and can occur after posterior fossa surgeries near the respiratory center. This is a serious complication and can be fatal. We report a case of a 39-year-old man patient who was able to breathe normally on command but lost the automatic breathing reflex after microsurgical for tumor ressection in the fourth ventricle. The patient underwent tracheostomy and was treated with several respiratory stimulants but these interventions proved ineffective. The patient was then transferred to a primary local healthcare facility while remaining ventilator-dependent. This case highlights the significant challenges in prognostication, management, and treatment of patients with acquired CHS.

Article Details

References

Amiel J, Laudier B, Attié-Bitach T, et al. Polyalanine expansion and frameshift mutations of the paired-like homeobox gene PHOX2B in congenital central hypoventilation syndrome. Nat Genet. 2003;33(4):459-461. doi:10.1038/ng1130
2. Sarnoff SJ, Whittenberger JL, Affeldt JE. HYPOVENTILATION SYNDROME IN BULBAR POLIOMYELITIS. Journal of the American Medical Association. 1951;147(1): 30-34. doi:10.1001/ jama.1951.03670180036007
3. Ratto O, Briscoe WA, Morton JW, Comroe JH. Anoxemia secondary to polycythemia and polycythemia secondary to anoxemia. Am J Med. 1955; 19(6): 958-965. doi:10.1016/0002-9343(55) 90162-5
4. Manconi M, Mondini S, Fabiani A, Rossi P, Ambrosetto P, Cirignotta F. Anterior Spinal Artery Syndrome Complicated by the Ondine Curse. Archives of Neurology. 2003;60(12):1787-1790. doi:10.1001/archneur.60.12.1787
5. Rad EF, Rad MF, Amini S, Zare R. Sleep Apnea Syndrome after Posterior Fossa Surgery: A Case of Acquired Ondine’s Curse. Iranian Journal of Otorhinolaryngology. 2015;27(78):63.
6. Karn M, Mahato BK, Sah R, Kandel D, Sapkota S. “You Sleep, You Die”: A Rare Clinical Case of Ondine’s Curse after Posterior Fossa Surgery. Case Rep Surg. 2023;2023:3113428. doi:10.1155/2023/3113428
7. Nannapaneni R, Behari S, Todd NV, Mendelow AD. Retracing “Ondine’s curse.” Neurosurgery. 2005;57(2):354-363; discussion 354-363. doi:10.1227/ 01.neu.0000166684. 69422.49
8. Pedroso JL, Baiense RF, Scalzaretto AP, Neto PB, Teixeira de Gois AF, Ferraz ME. Ondine’s curse after brainstem infarction. Neurol India. 2009;57(2):206-207. doi:10.4103/0028-3886.51298
9. Cielo C, Marcus CL. Central Hypoventilation Syndromes. Sleep medicine clinics. 2013;9(1): 105. doi:10.1016/j.jsmc.2013.10.005
10. Antic N, McEvoy RD. Primary alveolar hypoventilation and response to the respiratory stimulant almitrine. Intern Med J. 2002;32(12): 622-624. doi:10.1046/j.1445-5994.2002.00284.x