Central sleep apnea in a patient with Japanese encephalitis

We describe the first case of a patient with Japanese encephalitis suffering from central sleep apnea. The patient was a 58-year-old man who presented with high fever, semicomatose state, nuchal stiffness, and incontinence of feces. The patient had complication of severe pneumonia, and was ventilated with a respirator. After weaning from the respirator, desaturation of oxygen was observed during the night. Simplified polysomnography revealed a pure central apnea pattern. This case illustrates that Japanese encephalitis can result in central sleep apnea. Neurology Asia 2008; 13 : 77 – 81 Address correspondence to: Shiroh Miura, Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan. E-mail: [email protected] INTRODUCTION Central apnea is characterized by a lack of the drive to breathe and defined by a lack of respiratory effort during cessations of airflow.1 Japanese encephalitis (JE) has a significantly higher frequency of impaired respiratory disturbance when compared to other types of viral encephalitis.2 However, to our knowledge, there are no reports of central sleep apnea due to JE as proven by objective examination. In this report, we present a patient with JE who developed episodes of central sleep apnea confirmed by simplified PSG.