Obstructive sleep apnea in association with posterior fossa neurologic disease
S. Adelman, D. S. Dinner, H. Goren, J. Little and P. Nickerson
Sleep apnea in association with neurologic disease is uncommon, and its
documentation with nocturnal polysomnography (PSG) is rare. Two patients
with posterior fossa neurologic disease had obstructive and central sleep
apnea on PSG. The first was a 40-year-old woman who experienced a
respiratory arrest ten days after neurosurgical decompression of a cervical
syrinx associated with syringobulbia. Nocturnal PSG demonstrated
obstructive sleep apnea. Tracheostomy was performed and a second nocturnal
PSG showed no sleep apnea. The second patient was a 76-year-old woman with
daytime hypersomnolence, nocturnal choking spells, progressive spastic
paraparesis, and left-sided cerebellar tremor. Neurologic evaluation led to
the diagnosis of olivopontocerebellar degeneration. Nocturnal PSG showed
multiple episodes of central and obstructive apnea. These cases support the
hypothesis that central and obstructive sleep apnea can originate from a
central mechanism.
