Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0037315 (sleep apnea)
 8,000 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 4-week-old infant experienced prolonged central sleep apnea requiring resuscitation. At 6 months of age he developed episodic obstructive apnea (diagnosed as laryngospasm by direct laryngoscopy) with an abnormal EEG and a normal computed tomography (CT) scan, and at 14 months of age he developed hemiparesis due to a gemistocytic astrocytoma grade III-IV. Following removal of the mass, he has had occasional seizure activity, but no further episodes of obstructive apnea.
 ...
PMID:Astrocytoma in an infant with prolonged apnea. 742 32

Four boys aged 6-16 years with neurodevelopmental deficits were treated with CPAP for obstructive sleep apnoea. Their diagnoses were: Obesity with mild mental retardation, (2) attention deficit hyperactivity disorder, (3) epilepsy associated with left hemiparesis and (4) mild mental retardation due to fragile X syndrome. Previous therapeutic attempts, including adenotonsillectomy, amitriptyline and methylphenidate in our patients prior to CPAP treatment were unsuccessful. A follow-up period of 12-48 months demonstrated a number of clinical benefits such as improvement in sleep quality and daily arousal, and a decrease in the frequency of seizures and episodes of pneumonia. Polysomnographic studies indicated a significant improvement in sleep parameters such as apnoea frequency, awakenings, sleep efficiency and arterial oxygen saturation. Side effects were mild and readily alleviated. CPAP is a feasible therapeutic intervention in intractable obstructive sleep apnoea of childhood, even when associated with neurodevelopmental deficits.
 ...
PMID:CPAP treatment of obstructive sleep apnoea and neurodevelopmental deficits. 754 99

A hemimedullary infarction, in which both medial and lateral medullary infarctions occur simultaneously, is a rare cerebrovascular disease. Pontomedullary lesions often cause central respiratory failure, and the majority of central respiratory failures are due to bilateral pontomedullary lesions. We report a 66-year-old man with central respiratory failure due to a hemimedullary infarction detected by magnetic resonance imaging. He was admitted to our hospital on March 7, 1998, because of a sudden onset of dysarthria, and both numbness and weakness on his left side. Soon after arriving at the hospital, his spontaneous respiration ceased. Therefore, he was intubated and artificial ventilation was started. Pertinent neurological abnormalities on admission consisted of dysarthria, dysphagia, right Horner's sign, right gaze evoked horizontal nystagmus, right soft palate palsy, and tongue deviation to the right. In addition, left hemiparesis, left Babinski's sign, sensory impairment on the left side including the face, and central respiratory failure were noted. Although voluntary respiration recovered in 12 days, sleep apnea continued for 5 months, which was considered to be due to the automatic respiratory failure. An important feature of this patient was that the hemimedullary infarction caused the central respiratory failure. To our knowledge, this is the third patient whose central respiratory failure occurred because of a hemimedullary infarction.
 ...
PMID:[A case report of central respiratory failure due to hemimedullary syndrome]. 1118 17

Cyanotic breath-holding spell is a benign and self-limiting disease of young children but occasionally associated with sudden, unexpected death. The authors report a rare case in a 2-year-old girl with a severe form that started after radical resection of a cervicomedullary ganglioglioma. She was admitted to our hospital because of delayed and unstable gait. Since magnetic resonance imaging showed a cervicomedullary tumor, she underwent a radical resection and histology showed the tumor to be a ganglioglioma. Postoperatively, the function of the lower cranial nerves and cerebellum deteriorated and hemiparesis on the left became apparent, but she returned to the preoperative state in a few months. In addition, mild sleep apnea (Ondine curse) and severe cyanotic breath-holding spells occurred. The former responded to medication but the latter failed and continued several times per day with a rapid onset and progression of hypoxemia, loss of consciousness, sweating and opisthotonos. Five months after the operation, the patient returned home with a portable oxygen saturation monitor equipped with an alarm. This case indicates that cyanotic breath-holding spell, as well as sleep apnea, is critical during the early postoperative period. This is the first report observing that such spells may occur as a complication of radical resection of a cervicomedullary tumor.
 ...
PMID:Cyanotic breath-holding spell: a life-threatening complication after radical resection of a cervicomedullary ganglioglioma. 1594 80

Symptomatic vascular compression of the medulla oblongata causing brainstem dysfunction is extremely rare. Only a few case reports documenting the clinical condition of patients, diagnostic features and therapeutic options are available in literature. The Medline search revealed with the present cases a total of 9 reports on patients with symptomatic vertebral artery compression to the brainstem. Out of these reports the observed symptoms comprise hypertension, hemiparesis, tetraparesis, hemihypaesthesia, pyramidal tract signs, central sleep apnea and vertigo. Moreover an overview of the various suggested and published microsurgical procedures is given. Based on the literature search basically 4 different microsurgical strategies are documented, the vessel mobilization, the vessel section with posterior fossa decompression, the autologous material inlay with posterior fossa decompression and the lateral vessel retraction assisted with Gore-Tex. Vascular compression causing brainstem deficits are particularly unusual in the young population. Two illustrative cases of young men with a symptomatic vertebral artery brainstem conflict who were treated microsurgically with vascular decompression are additionally discussed in the present article. The history, diagnostic features, microsurgical treatment and outcome of these patients are described in detail. As a conclusion these cases demonstrated that careful examination can serve to determine the diagnosis even in the young population microsurgical treated successfully. In conclusion the present review tries to provide an overview of the existent data on the variety of clinical, radiological and surgical features in patients with symptomatic vascular brainstem compression.
 ...
PMID:Symptomatic vertebral artery conflicts to the medulla oblongata and microsurgical treatment options: review of the literature. 1915 14

A 27-year-old woman presented with a case of primary medulla oblongata germinoma manifesting as sleep apnea, aspiration pneumonia, and left hemiparesis. Magnetic resonance (MR) imaging revealed a dorsal mass in the medulla oblongata with heterogeneous enhancement by gadolinium (Gd). Emergent biopsy and foramen magnum decompression with C1 laminectomy were performed because of rapid worsening of her symptoms. The histological diagnosis was germinoma. Subsequently she received chemoradiation therapy with subsequent amelioration of her neurological deficits and disappearance of enhancement on MR imaging with Gd. Primary medulla oblongata germinoma is rare and difficult to diagnose preoperatively. However, correct diagnosis and subsequent adequate chemoradiation therapy is possible by understanding the common characteristics of the disease. Germinoma should be included in the differential diagnosis of midline medullary lesion in young patients, and biopsy should be considered.
 ...
PMID:Primary germinoma in the medulla oblongata - case report - . 2151 60