Nogués M A, Gené R, Encabo H
Instituto de Investigaciones Neurológicas Dr Raúl Carrea, FLENI, Buenos Aires, Argentina.
J Neurol Neurosurg Psychiatry. 1992 Jul;55(7):585-9. doi: 10.1136/jnnp.55.7.585.
Clinical, respiratory, and polysomnographic findings in three patients with syringomyelia and syringobulbia who developed severe respiratory complications are described. Neurological examination showed evidence of IXth and Xth cranial nerve involvement with dysphagia and dysphonia, but there were no complaints of serious sleep difficulties. Two patients died during sleep and the other was resuscitated during a nap. All patients showed moderate restrictive ventilatory defects with reduced maximal buccal pressures and one also showed a low ventilatory response to CO2 rebreathing. Protracted central, obstructive, and mixed apnoeas and hypopnoeas were commonly observed during sleep. There were no changes in heart rate during these events. A combination of respiratory and cardiovascular mechanisms might have been responsible for the severe complications described.
描述了3例患有脊髓空洞症和延髓空洞症并发生严重呼吸并发症患者的临床、呼吸及多导睡眠图检查结果。神经学检查显示有吞咽困难和发音障碍的第IX和第X对脑神经受累迹象，但并无严重睡眠困难的主诉。2例患者在睡眠中死亡，另1例在午睡时被复苏。所有患者均表现出中度限制性通气缺陷，最大口腔压力降低，1例患者对二氧化碳再呼吸的通气反应也较低。睡眠期间常观察到持续性中枢性、阻塞性和混合性呼吸暂停及呼吸浅慢。这些事件期间心率无变化。呼吸和心血管机制的联合作用可能是所述严重并发症的原因。
