Related Experiment Videos
[Central apnea with consciousness impairment due to Listeria rhombencephalitis sequelae]
D Milhaud1, G Bernardin, P M Roger
1Service de Réanimation Neurologique, CHU Montpellier.
Abstract:
Listeria neuromeningitis presents as febrile rhombencephalitis in half the patients, often with persistent sequelae such as cranial nerve palsy. We report the case of a man who developed central apnea with simultaneous consciousness impairment subsequent to an infectious disease. Magnetic resonance imaging showed low signal intensities in T1 and T2, particularly in the medulla. Neither acidosis, hypoxia nor hypercapnea stimulated the respiratory centers during episodes of apnea; ventilation started again only with strong voluntary stimulation. Pons and medulla lesions of the reticular formation were probable as well as lesions of the automatic respiratory system and could explain the central origin of the apnea in this patient.
Insights
Listeria neuromeningitis can cause rhombencephalitis and cranial nerve palsies. A case study reveals central apnea and consciousness impairment due to brainstem lesions, highlighting potential respiratory control disruption.
Area of Science:
- Neurology
- Infectious Diseases
- Respiratory Medicine
Background:
- Listeria neuromeningitis is a severe bacterial infection affecting the central nervous system.
- It can manifest as rhombencephalitis, often leading to neurological deficits like cranial nerve palsies.
Observation:
- A patient developed central apnea and impaired consciousness following an infectious disease.
- Brain imaging revealed T1 and T2 low signal intensities, predominantly in the medulla.
Findings:
- Respiratory centers were unresponsive to physiological stimuli (acidosis, hypoxia, hypercapnia).
- Ventilation resumed only with voluntary stimulation, suggesting a disruption of automatic respiratory control.
- Lesions in the pons and medulla, specifically the reticular formation, are implicated.
Implications:
- This case highlights a rare presentation of Listeria neuromeningitis affecting respiratory drive.
- Understanding these brainstem lesion effects is crucial for managing neurological complications of infections.
- Further research into the mechanisms of central apnea in infectious encephalitis is warranted.