Ondine’s Syndrome as a Postoperative Complication of High Cervical Cordotomy: a case series review

Síndrome de Ondine Como Complicação Pós-operatória da Cordotomia Cervical Alta: uma revisão de série de casos

• Arthur Oliveira Lira (1)    
• Marcelo Diniz de Menezes (2)    
• Matheus Oliveira Lira (3)    
• Joaquim Fechine de Alencar Neto (1)    
• Luiz Bandeira Alves Neto (4)    
• Melissa Helena Rodrigues Silva (5)    
• Nilson Batista Lemos (6)    
• Maria Luísa Rocha (7)    
• Otávio da Cunha Ferreira Neto (8)    
• Luís Felipe Ferreira Marques (9)    
• Victor Egypto Pereira (10)    
• Anderson Albert Primo Lopes (11)    
• Luiz Severo Bem Junior (12)    
• Hildo Rocha Cirne de Azevedo Filho (13) (14) (15)    

• https://doi.org/10.22290/jbnc.2022.330309
• J Bras Neurocirur 33 (3): 389-393, 2022

Resumo

A maldição de Ondine é o termo usado para descrever a apneia do sono causada por danos nas vias da medula espinhal de controle respiratório. Apesar de serem apresentadas várias causas, a síndrome de Ondine é reconhecida como uma complicação pós-operatória comum e fatal da cordotomia cervical superior para o controle da dor maligna. Nosso objetivo é realizar uma revisão histórica baseada em artigos ligados às bases de dados PubMed e Scielo, de forma a analisar a frequência e evolução da apneia do sono em pacientes submetidos a cordotomia cervical superior, além de observar o mecanismo anatômico e funcional que a desencadeia. Os resultados obtidos revelam que a síndrome pós-operatória de Ondine é causada pela seção dos tratos espinotalâmicos e espiroreticulares laterais, que estão localizados na porção anterolateral da medula espinhal.

Palavras-chave

Síndrome de Ondine; Apneia do sono; Cordotomia; Automaticidade respiratória; Controle de respiração

Abstract

Ondine’s curse is the term used to describe sleep apnea caused by damage to the spinal cord pathways of respiratory control. Despite presenting several causes for this syndrome, Ondine’s syndrome is recognized as a common and fatal postoperative complication of upper cervical cordotomy for malignant pain control. Our objective is to carry out a historical review based on papers linked to PubMed and Scielo databases in order to analyze the frequency and evolution of sleep apnea in patients undergoing upper cervical cordotomy, in addition to observing the anatomical and functional mechanism that triggers it. The results revealed that postoperative Ondine’s syndrome is caused by sectioning of the lateral spinothalamic and spinoreticular tracts, which are located in the anterolateral portion of the spinal cord.

Keywords

Ondine’s syndrome; Sleep apnea; Cordotomy; Respiratory automaticity; Breathing control

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1 Medical student, College of Medical Sciences, Unifacisa University Center, Campina Grande, PB, Brazil.

2 Medical student, Pernambucano College of Health, Recife, PE, Brazil.

3 Medical student, Federal University of Campina Grande, Campina Grande, PB, Brazil.

4 Medical student, University of Pernambuco, Recife, PE, Brazil.

5 Medical student, Catholic University of Pernambuco, Recife, PE, Brazil.

6 Medical student, College of Medical Sciences, Unifacisa University Center, Campina Grande, PB, Brazil.

7 Medical student, Brasília University Center, Brasília, DF, Brazil.

8 Medical student, Catholic University of Pernambuco, Recife, PE, Brazil.

9 Medical student, Federal University of Mato Grosso, Cáceres, MT, Brazil.

10 MD, Anesthesia and Pain, Department of Orthopedics and Anesthesiology, University of São Paulo, Ribeirão Preto, SP, Brazil.

11 MD, Neurosurgery Department, Hospital da Restauração, Recife, PE, Brazil.

12 MD, Neurosurgery Department, Hospital da Restauração, College of Medical Sciences, Unifacisa University Center, Campina Grande, PB, Brazil.

13 MD, PhD, Neurosurgeon, Neurosurgery Department, Hospital da Restauração, Recife, PE, Brazil.

14 Professor of Neurology and Neurosurgery, University of Pernambuco, Recife, PE, Brazil.

15 Professor, Unifacisa University Center, Campina Grande, PB, Brazil.

 

Received Jun 21, 2022

Accepted Jul 12, 2022