Central neurogenic hyperventilation: pharmacologic intervention with morphine sulfate and correlative analysis of respiratory, sleep, and ocular motor dysfunction.

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Publication Type Journal Article
School or College School of Medicine
Department Anesthesiology; Ophthalmology; Neurosurgery; Neurology
Creator Jaeckle, Kurt A.; Digre, Kathleen B.; Jones, Christopher R.; Bailey, Peter L.
Other Author McMahill, Phillip C.
Title Central neurogenic hyperventilation: pharmacologic intervention with morphine sulfate and correlative analysis of respiratory, sleep, and ocular motor dysfunction.
Date 1990-11
Description Central neurogenic hyperventilation (CNH), for which there is no effective therapy, can eventually result in respiratory fatigue and death. This report describes a patient with CNH due to a brainstem anaplastic astrocytoma who also exhibited disturbances of sleep and ocular motor function. The CNH responded clinically to morphine sulfate and methadone. Analysis of ventilatory response to CO2 before and after morphine demonstrated a depression of ventilatory response (49 to 53% of baseline) and occlusion pressure response (35 to 50% of baseline) to CO2, with a requirement for high doses of naloxone (10 mg IV) to reverse the effect. Polysomnography revealed sustained hyperventilation, elevated O2 saturation, and low end-tidal CO2 throughout all stages of non-rapid eye movement (NREM) sleep, and absence of rapid eye movement (REM) sleep. Ocular motor evaluation disclosed absence of horizontal and reflexive saccades with compensatory head thrusts. Correlation of the clinical and physiologic data with the MRI abnormalities suggested that the lesion responsible for CNH in this patient might reside in the medial tegmental parapontine reticular formation. Since recurrent episodes of hyperventilation responded in a sustained fashion to IV and oral opiates, this treatment may warrant consideration in other patients with CNH.
Type Text
Publisher Lippincott, Williams & Wilkins
Volume 40
Issue 11):1715-20. Retrieved on February 23,2007 from Neurology. 1990 Nov;40(11
First Page 1715
Last Page 1720
Subject Central Neurogenic H yperventilation; Ocular Motor Dysfunction
Subject MESH Astrocytoma; Brain Neoplasms; Drug Therapy; Eye Movements; Hyperventilation; Methadone; Morphine; Respiration
Language eng
Bibliographic Citation Jaeckle KA, Digre KB, Jones CR, Bailey PL, McMahill PC. Central neurogenic hyperventilation: pharmacologic intervention with morphine sulfate and correlative analysis of respiratory, sleep, and ocular motor dysfunction. Neurology. 1990 Nov;40(11):1715-20. Retrieved on February 23,2007 from Neurology. 1990 Nov;40(11):1715-20. Retrieved on February 23, 2007 from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=Display&DB=pubmed
Rights Management Copyright © Wolters Kluwer, Neurology, 40, 1715-20, 1990
Format Medium application/pdf
Identifier ir-main,798
ARK ark:/87278/s67w6wb5
Setname ir_uspace
Date Created 2012-06-13
Date Modified 2012-06-13
ID 703313
Reference URL https://collections.lib.utah.edu/ark:/87278/s67w6wb5
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