title: Central neurogenic respiratory failure: a challenging diagnosis.
abstract: BACKGROUND
  Central nervous system lesions are rare causes of respiratory failure. Simple observation of the breathing pattern can help localize the lesion, but the examiner needs to be aware of potential pitfalls such as metabolic or pulmonary alterations.
  
  
  METHODS
  We describe 3 cases in which central neurogenic respiratory failure occurred simultaneously with other alterations or in an unusual presentation.
  
  
  RESULTS
  All patients were diagnosed with central neurogenic respiratory failure and treated for it with good recovery.
  
  
  CONCLUSIONS
  Central neurogenic respiratory failure is a challenging diagnosis and needs to be reminded in difficult-to-wean patients carrying inconclusive evidences of metabolic or pulmonary alterations.
authors.affiliation: Department of Neurology and Neurosurgery, Federal University of São Paulo, School of Medicine, São Paulo, Brazil.
authors.forename: Flávio A
authors.initials: FA
authors.lastname: Carvalho
authors.forename: Tenille
authors.initials: T
authors.lastname: Bernardino
authors.forename: Ricardo O H
authors.initials: RO
authors.lastname: Maciel
authors.forename: Sérgio F A
authors.initials: SF
authors.lastname: Felizola
authors.forename: Eduardo L V
authors.initials: EL
authors.lastname: Costa
authors.forename: Gisele S
authors.initials: GS
authors.lastname: Silva