Central Hypoventilation Syndrome in Posterior Circulation Stroke Treated by Respiratory Rehabilitation: a Case Report
- Author:
Mee Gang KIM
1
;
Bomi SUL
;
Bo Young HONG
;
Joon Sung KIM
;
Seong Hoon LIM
Author Information
- Publication Type:Case Report
- Keywords: Stroke; Respiratory Center; Hypoventilation; Central Hypoventilation Syndrome; Respiratory Rehabilitation; Cerebellar Hemorrhage
- MeSH: Abdominal Muscles; Apnea; Central Nervous System Diseases; Cerebellum; Electric Stimulation; Female; Follow-Up Studies; Humans; Hypercapnia; Hypoventilation; Insufflation; Middle Aged; Pneumonia; Quality of Life; Range of Motion, Articular; Rehabilitation; Respiration; Respiratory Center; Spirometry; Stroke; Thoracic Wall; Tracheostomy; Upper Extremity; Ventilators, Mechanical; Weaning
- From:Brain & Neurorehabilitation 2019;12(1):e4-
- CountryRepublic of Korea
- Language:English
- 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.
