Periodic breathing and dysphagia associated with a localized lateral medullary infarction.
A 77-year-old man experienced sudden onset of dysphagia. An MRI revealed a left lateral medullary infarction. Portable polysomnography showed Cheyne-Stokes-like breathing with marked desaturation (lowest SaO(2) 74%) associated with apnoea. Oxygen administration reduced the apnoea-hypopnoea index from 30.1 to 20.0 per hour. Sustained periodic breathing under normoxaemia suggested that the brainstem lesion, rather than peripheral factors such as prolonged lung-chemoreceptor circulatory delay, was responsible for the abnormal breathing. Polysomnography or overnight SaO(2) monitoring should be considered for patients with dysphagia due to a brainstem lesion, to investigate the possible presence of abnormal breathing.
Oku
Yoshitaka
Y
Department of Physiology, Hyogo College of Medicine, Nishinomiya, Japan.
Okada
Masahiro
M
D000368:Aged; D002544:Cerebral Infarction / Q000150:complications* / Q000503:physiopathology; D002639:Cheyne-Stokes Respiration / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D003680:Deglutition Disorders / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D017286:Polysomnography