This report describes a rare case of acquired Ondine's curse. The patient developed central sleep apnea syndrome named Ondine's curse after a brainstem infarction. Lesions involving the descending medullocervical pathways that subserve automatic breathing can result in this syndrome.

Ginkgo biloba is a herbal medication that is often used worldwide. Although side effects are uncommon, G. biloba has been associated with serious bleeding complications, especially intracranial hemorrhage. We report the case of a young woman who made chronic use of G. biloba and suffered from cerebral bleeding without any structural abnormalities. Several studies have pointed to the association between G. biloba and intracranial hemorrhage.

The most frequent neurologic manifestations of hepatitis C virus infection include peripheral neuropathy axonal type and central nervous system (CNS) vasculitis. Affected patients usually have cryoglobulinemia and other signs of vasculitis. Demyelinating lesions, both central and peripheral are rarely described. We present a case of simultaneous peripheral nervous system and CNS demyelination that comes in relapsing episodes, with negative cryoglobulins.

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A 27-year-old woman presented with sudden onset left-sided numbness and double vision. In the last 10 years, she developed diabetes mellitus, cataract, osteoarthritis, osteoporosis, benign neoplasm of the skull, epilepsy, and nonscarring alopecia. Her parents were first-degree relatives and there were no relatives with similar disease. On examination there were right internuclear ophthalmoplegia, short stature, tight skin, hyperkeratosis (figure 1), cataract, and mild cognitive impairment. Brain MRI disclosed acute brainstem ischemic infarct and severe leukoaraiosis with multiple old lacunar infarcts secondary to small-vessel disease (figure 2). Antinuclear antibodies and anticardiolipin and lupus anticoagulant antibodies were normal or negative. Genetic testing was not available.The patient presents with 5 cardinal and 3 minor features of Werner syndrome, which is an unusual autosomal recessive inherited disorder caused by mutations in the WRN gene on chromosome 8.1 It encodes a protein with helicase and exonuclease activities, absence of which leads to abnormalities in several DNA repair and processing pathways. Werner syndrome is the most common adult-onset progeria. The disease is characterized by premature aging and propensity for cancer.