Brain Neurorehabil.  2019 Mar;12(1):e4. 10.12786/bn.2019.12.e4.

Central Hypoventilation Syndrome in Posterior Circulation Stroke Treated by Respiratory Rehabilitation: a Case Report

Affiliations
  • 1Department of Rehabilitation Medicine, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea. seonghoon@catholic.ac.kr
  • 2Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Abstract

Central hypoventilation syndrome is a rare and fatal condition resulting from various central nervous system disorders that is characterized by a failure of automatic breathing. We report a case of central hypoventilation syndrome following posterior circulation stroke whose pulmonary function was improved by respiratory rehabilitation. A 59-year-old woman with a history of hemorrhagic stroke of the bilateral cerebellum was hospitalized due to pneumonia. A portable ventilator was applied via tracheostomy, recurrent episodes of apnea and hypercapnia impeded weaning. A respiratory rehabilitation program including chest wall range of motion exercise, air stacking exercise, neuromuscular electrical stimulation (NMES) on abdominal muscles, upper extremity ergometer, locomotor training, high-frequency chest wall oscillator, mechanical insufflation, and exsufflation was employed, as spirometry showed a severe restrictive pattern. A spontaneous breathing trial was started, and a portable ventilator was applied for 8 hours, only during nighttime, to prevent sudden apneic event. After 4 weeks of treatment, follow-up spirometry showed much improved respiratory parameters. This case suggests that respiratory rehabilitation can improve pulmonary function parameters and quality of life in central hypoventilation syndrome.

Keyword

Stroke; Respiratory Center; Hypoventilation; Central Hypoventilation Syndrome; Respiratory Rehabilitation; Cerebellar Hemorrhage
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