Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, Washington.
Division of Genetic Medicine, Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, Washington.
J Clin Sleep Med. 2023 Apr 1;19(4):843-849. doi: 10.5664/jcsm.10452.
This is the first case report of sleep-disordered breathing in patients with pontine tegmental cap dysplasia, a very rare neurological disorder characterized by an anatomic malformation in the pons. Patients present with hypotonia, cognitive dysfunction, and cranial nerve palsies (eg, hearing loss, trigeminal anesthesia, and swallow dysfunction). Extensive studies have demonstrated the relevance of different pontine neuronal nuclei in breathing regulation, which are structurally abnormal in pontine tegmental cap dysplasia. We present detailed polysomnography data for 3 patients aged 41 years, 20 years, and 1.5 years revealing significant central sleep apnea. We discuss our experience with managing their sleep-disordered breathing in the setting of multiple cranial nerve palsies and corneal anesthesia, and its relative contraindication of noninvasive positive pressure ventilation treatment.
Ju Wang J-D, Doherty D, Ramirez J-M, Chen M. Central sleep apnea in patients with pontine tegmental cap dysplasia treated with supplemental oxygen: a case report. . 2023;19(4):843-849.
中文译文:
本研究为桥脑被盖帽畸形患者睡眠呼吸障碍的首报病例。桥脑被盖帽畸形是一种非常罕见的神经发育障碍,以桥脑的解剖结构畸形为特征。患者常表现为张力减退、认知功能障碍和颅神经麻痹(如听力丧失、三叉神经感觉缺失和吞咽功能障碍)。大量研究已经证明了不同桥脑神经元核在呼吸调节中的相关性,这些核在桥脑被盖帽畸形中结构异常。我们报告了 3 例年龄分别为 41 岁、20 岁和 1.5 岁的患者的详细多导睡眠图数据,这些患者均存在显著的中枢性睡眠呼吸暂停。我们讨论了我们在多发性颅神经麻痹和角膜麻醉的情况下管理他们睡眠呼吸紊乱的经验,以及其对无创正压通气治疗的相对禁忌证。
Ju Wang J-D, Doherty D, Ramirez J-M, Chen M. Central sleep apnea in patients with pontine tegmental cap dysplasia treated with supplemental oxygen: a case report.. 2023;19(4):843-849.