Central Tapia’s syndrome (“matador’s disease”) caused by metastatic hemangiosarcoma

Abstract

The Spanish otorhinolaryngologist Antonio Garcia Tapia described in 1906 a lesion of the vagus and hypoglossus nerves with contralateral hemiplegia in a matador with bullhorn-induced wounds of the neck.1 Almost all later publications described Tapia syndrome as a peripheral disease of the X and XII cranial nerves. The extremely rare central Tapia syndrome is characterized by hemiparesis, often with hemihypesthesia contralateral to the cranial nerves palsies. It is caused by nuclear lesions of the nucleus ambiguus of the vagal and glossopharyngeal nerve and the nucleus of hypoglossal nerve2 combined with a lesion of the pyramidal tract.3 We report a patient with Tapia syndrome caused by metastatic hemangiosarcoma in the medulla oblongata. A 77-year-old man was referred with distinct weight loss, progressive weakness of his right leg, hoarseness, and swallowing and speech disturbances for 3 months. On admission, he was alert and oriented. Speech was hoarse and dysarthric; the soft palate moved asymmetrically to the right side. He had …