Central Hypoventilation Syndrome during Awake and Sleep

J Korean Neurol Assoc > Volume 18(5); 2000 > Article

Journal of the Korean Neurological Association 2000;18(5): 645-649.

각성 시와 수면 시에 발생한 중추성 호흡 곤란 증후군

김혜식, 박성민 한시령 김영인

가톨릭대학교 의과대학 신경과학교실

Central Hypoventilation Syndrome during Awake and Sleep

Hye-Sik Kim, M.D., Seong-Min Park, M.D., Si-Ryung Han, M.D., Yeong-In Kim, M.D.

Department of Neurology, College of Medicine, The Catholic University of Korea

Abstract

Central hypoventilation syndrome (CHS) can be caused by any lesions to the medullary respiratory centers, cerebral cortex, corticospinal pathways, and their connections. We report 5 patients with central hypoventilation syndrome and analyzed 26 patients who experienced central hypoventilation syndrome during sleep and waking states. We compared initial clinical symptoms and signs, maximal neurologic deficits, brain MRI and pathologic findings, and associated autonomic dysfunctions. The patients with respiratory failure during waking states showed quadriplegia, a rapidly pro-gressing respiratory failure. The patients who had automatic respiratory failure showed mild hemiparesis, bulbar dys-function, dysautonomia, and subacute to chronic recurrent respiratory failures. These results support the concept of two separate respiratory systems: a voluntary system and an automatic system. The respiratory management of these patients with central hypoventilation syndrome should be considered critical to their survival. J Korean Neurol Assoc 18(5):645~649, 2000 Key Words : Central hypoventilation syndrome, Respiratory center, Pyramidal tracts, Magnetic resonance imaging