Aktuelle Neurologie 2007; 34 - P535
DOI: 10.1055/s-2007-987806

Control of breathing in patients with brainstem lesions

ME Schläfke 1, C Zumfelde 1, B Luka 1, T Schäfer 1, W Greulich 1
  • 1Hagen, Bochum

In order to analyze the impact of brainstem strokes at different sites on the control of respiration in human beings, we correlated MRT-located ischemic brainstem lesions with sleep-related breathing disorders, measured by whole-night polysomnography, and the hypercapnic ventilatory drive during wakefulness, using a steady-state test, in 18 patients (17 men, mean age: 57yrs, range 44–72yrs), suffering from medullary/cerebellar lesions (group M, n=5), isolated pontine lesions (group P, n=7) and combined lesions of the pons and other midbrain regions (group P+, n=6). Patients were examined 6.5 (median, IqR 5.8) weeks after the incident. The HCVR slopes significantly differed between P (1.9±0.5l/min/Torr) and P+ (0.7±0.5l/min/Torr, p<0.005, ANOVA), with M at 1.2±0.7l/min/Torr (n.s.). P tended to lower apnea-hypopnea indices (AHI; P: 7.6±6.5/h; P+: 23.3±25.6/h; M: 25.0±19.5/h; n.s.). M, P and P+ had comparable BMI values, but 3/5 patients of group M, 3/6 of group P+, but only 1/7 of group P had an AHI above 15/h. We conclude that in contrast to isolated pontine lesions, combined pontine/midbrain lesions coincide with a reduced hypercapnic ventilatory response and a tendency towards sleep-related breathing disorders.