A patient who developed an acute demyelinating lesion in the region of the cervicomedullary junction showed the rare combination of paralyzed movements of the chest and limbs with preservation of spontaneous breathing. For a while breathing was autonomous in that he could neither take a voluntary breath nor stop breathing. The cough reflex was preserved. Observations indicate that voluntary movements of the respiratory muscles can be achieved independently of any direct action on the medullary neurons generating the respiratory drive. Further, voluntary arrest of spontaneous breathing may depend on an inhibition exerted at the termination of the pathway carrying the central respiratory drive rather than centrally on respiratory neurons.
Davis JN. Autonomous Breathing: Report of a Case. Arch Neurol. 1974;30(6):480–483. doi:10.1001/archneur.1974.00490360056011
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