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To the Editor:
Experiments in cats identified a concentration of cells in the rostral dorsolateral pontomedullary area, stimulation of which causes sneezing indistinguishable from sneezing induced by natural peripheral stimuli.1 The effect of ablation of these cells has not been studied, but in humans one case with a medullary tumor2 and four cases with lateral medullary syndrome3 have been described with abortive sneeze reflex (ASR). The inspiratory phase was not followed by the explosive expiratory phase in these individuals, although it could voluntarily be reproduced. All five cases experienced complete recovery of the sneeze reflex within months. The most recent description of a patient with systemic lupus erythmatosus–related demyelination who had ASR with a persisting lesion in the area of sneeze center4 is further evidence that ASR results from a well-defined brainstem lesion.
The subject may, however, be more complex, as the following case illustrates. The patient was a 79-year-old man with sudden onset of right facial weakness and right hemiparesis. Subsequently, he became obtunded and disoriented; …
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