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January 1964

Apneustic Breathing in Man

Author Affiliations

From the divisions of neurology and neuropathology, University of Washington School of Medicine, and the Department of Neurology, New York Hospital-Cornell Medical Center.

Arch Neurol. 1964;10(1):101-112. doi:10.1001/archneur.1964.00460130105014

Apneustic breathing with respiration arrested in tonic inspiration is rare in man. Clinical reports of respiratory abnormalities following the 1919-1921 influenza-encephalitis pandemic include descriptions of inspiratory breath holding, which may have been physiological apneusis.1 Apneusis has been described in a premature infant with medullary hemorrhages.2 However, previous physiological or pathological studies on adult humans with tonic inspiratory pnea are laking.

We present here examples of well-documented apneustic breathing in two adults, both of whom had lesions destroying the dorsal-lateral pons rostral to the trigeminal nerves. Neither patient had lesions involving vagal pathways or medulla oblongata. Since these humans did not have the combined pontine-vagal lesions associated classically with apneusis in animals,3,4 their findings prompted us to re-examine traditional concepts of central respiratory control.

Background  Apneusis was given its identity its identity by Marckwald3 in 1888 and its name by Lumsden4 in 1923. Marckwald (and several