Sneeze related area in the medulla: localisation of the human sneezing centre?
Sneezing is a rarely explored symptom in neurological practice. In the cat, a sneeze evoking centre is located in the medulla. The existence of a sneezing centre has not been confirmed in humans. A case with abnormal sneezing secondary to a strategic infarct in the right latero-medullary region is presented. A 66 year old man suddenly presented paroxysmal sneezing followed by ataxia, right sided motor and sensory symptoms, and hoarseness. The application of stimuli to the right nasal fossa did not evoke sneezing nor the wish to sneeze. The same stimuli to the contralateral nasal fossa evoked normal sneezing. The preservation of the superficial sensitivity of the nasal fossa indicates that the lesion was localised in the hypothetical human sneezing centre, very close to the spinal trigeminal tract and nucleus. This centre appears to be bilateral and functionally independent on both sides.
Seijo-Martínez
M
M
Neurology Service, Hospital do Salnés, Ande-Rubians, Villagarcia de Arosa, 36.619 Pontevedra, Spain. mseijom@meditex.es
Varela-Freijanes
A
A
Grandes
J
J
Vázquez
F
F
D000368:Aged; D001259:Ataxia / Q000209:etiology; D001921:Brain / Q000473:pathology; D002211:Capsaicin / Q000494:pharmacology / Q000627:therapeutic use; D002544:Cerebral Infarction / Q000150:complications / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008526:Medulla Oblongata / Q000502:physiology*; D009296:Nasal Cavity / Q000187:drug effects; D012912:Sneezing / Q000502:physiology*; D014279:Trigeminal Nucleus, Spinal / Q000473:pathology
D002211:Capsaicin