Ondine’s Curse and its Inverse Syndrome

Breathing is controlled separately by the autonomic and voluntary pathways, which are, at least partially, anatomically different1,2. Rarely, a discrete lesion of the central nervous system may produce a selective paralysis of one type of respiration, but spare another. Recently, we encountered a patient with the paralysis of autonomic respiration (Ondine’s curse) of unknown etiology, in whom the voluntary respiration remained intact. Then, we encountered another patient with its inverse clinical feature, in whom a localized, traumatic damage of the cerebral peduncle had induced a complete loss of voluntary respiration, while the autonomic respiration remained intact.