Abnormalities of respiratory control and the respiratory motor unit.
BACKGROUND
Control of ventilation depends on a brainstem neuronal network that controls activity of the motor neurons innervating the respiratory muscles. This network includes the pontine respiratory group and the dorsal and ventral respiratory groups in the medulla. Neurologic disorders affecting these areas or the respiratory motor unit may lead to abnormal breathing.


RESULTS
The brainstem respiratory network contains neurons critical for respiratory rhythmogenesis; this network receives inputs from peripheral and central chemoreceptors sensitive to levels of carbon dioxide (PaCO2) and oxygen (PaO2) and from forebrain structures that control respiration as part of integrated behaviors such as speech or exercise. Manifestations associated with disorders of this network include sleep apnea and dysrhythmic breathing frequently associated with disturbances of cardiovagal and sympathetic vasomotor control. Common disorders associated with impaired cardiorespiratory control include brainstem stroke or compression, syringobulbia, Chiari malformation, high cervical spinal cord injuries, and multiple system atrophy. By far, neuromuscular disorders are the more common neurologic conditions leading to respiratory failure.


CONCLUSIONS
Respiratory dysfunction constitute an early and relatively major manifestation of several neurologic disorders and may be due to an abnormal breathing pattern generation due to involvement of the cardiorespiratory network or more frequently to respiratory muscle weakness.
Nogués
Martín A
MA
Department of Neurology, Instituto de Investigaciones Neurologicas Raul Carrea (FLENI), Buenos Aires, Argentina. mnogues@fleni.org.ar
Benarroch
Eduardo
E
D006801:Humans; D009046:Motor Neurons / Q000502:physiology*; D012120:Respiration Disorders / Q000209:etiology / Q000473:pathology*; D012125:Respiratory Center / Q000473:pathology* / Q000503:physiopathology*; D012137:Respiratory System / Q000503:physiopathology