Central Sleep Apnea and Respiratory Arrest after Unilateral Lateral Medullary Infarction

Background: Central sleep apnea is characterized by loss of automatic respiration during sleep. There are only a few reports which document that medullary infarction resulted in central sleep apnea and failure in early recognition of this condition could be catastrophic. We report a case of central sleep apnea following lateral medullary infarction. Case Report: A 49-year-old woman with an unknown past history presented with sudden onset of dizziness, loss of balance, and dysarthria for 1-hour duration. Diffusion-weighted imaging confirmed right lateral medullary infarction. She had episodes of hypercapnia and respiratory arrest due to central sleep apnea, which was confirmed by polysomnography. Tracheostomy was performed and she was put on a home ventilator. After 3 months, follow-up polysomnography showed disappearance of central sleep apnea. Conclusion: Patients with lateral medullary infarction need to be monitored closely with respect to the respiratory pattern.