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Steven Adelman, DO; Dudley S. Dinner, MD; Hershel Goren, MD; John Little, MD; Paul Nickerson, MD

Arch Neurol. 1984;41(5):509-510.

Abstract
• 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 para-paresis, 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.

Author Affiliations
From the Departments of Neurology (Drs Adelman, Dinner, and Goren), Neurosurgery (Dr Little), and Internal Medicine (Dr Nickerson), Cleveland Clinic Foundation.

Footnotes
Accepted for publication June 24, 1983.

Reprint requests to Department of Neurology, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44106 (Dr Dinner).

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