Skip Navigation

This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (49)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by HOWARD, R. S.
Right arrow Articles by NEWSOM-DAVIS, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by HOWARD, R. S.
Right arrow Articles by NEWSOM-DAVIS, J.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Brain, Vol. 115, No. 2, 479-494, 1992
© 1992 Oxford University Press

research-article

RESPIRATORY INVOLVEMENT IN MULTIPLE SCLEROSIS

R. S. HOWARD1,2, C. M. WILES1,*, N. P. HIRSCH1, L. LOH1,*,*, G. T. SPENCER2 and J. NEWSOM-DAVIS1,*,*

1Batten/Harris Unit, National Hospital for Neurology and Neurosurgery London, UK 2Lane Fox Respiratory Unit, St Thomas' Hospital London, UK

Correspondence to: Correspondence to Dr R. S. Howard, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK

Respiratory complications occur in advanced multiple sclerosis (MS) but may also complicate acute relapses earlier in the disease. We present 19 patients with MS who developed respiratory complications at a mean of 5.9 (range 1–12) yrs after the onset of neurological symptoms.

Fourteen patients developed severe respiratory insufficiency presenting with a combination of reduced forced vital capacity (FVC), hypoxaemia or hypercapnia (12 patients) and respiratory arrest (four patients). Two patients presented with apneustic breathing, one with paroxysmal hyperventilation, one with obstructive sleep apnoea and one with bulbar weakness leading to aspiration pneumonia. Respiratory muscle weakness was a major factor in 14 patients (predominantly diaphragm involvement in six), bulbar weakness in seven patients, impaired voluntary control in three and impaired automatic control in three.

Twelve patients received mechanical respiratory support of whom seven have subsequently died The methods of support used were intermittent positive pressure ventilation (nine patients), iron lung (three), cuirass (two) and rocking bed (one) Six patients were maintained on respiratory support until they died after intervals varying from 24 h to 6 yrs (mean 17.7 mths). Five patients received temporary ventilation for between 6 d and 42 d: of these four remain alive at up to 4 yrs and one died after 16 yrs. One patient remains on domiciliary nasal intermittent positive pressure ventilation (IPPV) after 1 yr

.

Received June 20, 1991. Revised December 31, 1991. Accepted January 30, 1992.

*Present address: University of Wales College of Medicine, Heath Park, Cardiff CF4 4XW, UK

**Present address Radcliffe Infirmary, Woodstock Road, Oxford OX2 6HE, UK.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Mult SclerHome page
R. O'Sullivan, I. Brown, and M. Pender
Apneusis responding to buspirone in multiple sclerosis
Multiple Sclerosis, June 1, 2008; 14(5): 705 - 707.
[Abstract] [PDF]

Home page
 J. Neurol. Neurosurg. PsychiatryHome page
S J Pittock, B G Weinshenker, and E F M Wijdicks
Mechanical ventilation and tracheostomy in multiple sclerosis
J. Neurol. Neurosurg. Psychiatry, September 1, 2004; 75(9): 1331 - 1333.
[Abstract] [Full Text] [PDF]

Home page
 J. Neurol. Neurosurg. PsychiatryHome page
R. S Howard, D. M Kullmann, and N. P Hirsch
Admission to neurological intensive care: who, when, and why?
J. Neurol. Neurosurg. Psychiatry, September 1, 2003; 74(90003): iii2 - 9.
[Full Text] [PDF]

Home page
 J. Neurol. Neurosurg. PsychiatryHome page
R. S Howard and C. Davidson
Long term ventilation in neurogenic respiratory failure
J. Neurol. Neurosurg. Psychiatry, September 1, 2003; 74(90003): iii24 - 30.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
F. Laghi and M. J. Tobin
Disorders of the Respiratory Muscles
Am. J. Respir. Crit. Care Med., July 1, 2003; 168(1): 10 - 48.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
S. J. Pittock, M. Rodriguez, and E. F. M. Wijdicks
Rapid Weaning from Mechanical Ventilator in Acute Cervical Cord Multiple Sclerosis Lesion After Steroids
Anesth. Analg., December 1, 2001; 93(6): 1550 - 1551.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
B. Caruana-Montaldo, K. Gleeson, and C. W. Zwillich
The Control of Breathing in Clinical Practice*
Chest, January 1, 2000; 117(1): 205 - 225.
[Abstract] [Full Text] [PDF]

Home page
 Mult SclerHome page
A. D Rae-Grant, N. J Eckert, S. Bartz, and J. F Reed
Sensory symptoms of multiple sclerosis: a hidden reservoir of morbidity
Multiple Sclerosis, June 1, 1999; 5(3): 179 - 183.
[Abstract] [PDF]

Home page
 ChestHome page
R. v. Klaveren, T. Buyse, L. V. D. Gaer, J. Meekers, F. Rochette, and M. Demedts
Micturitional Disturbances Are Associated With Impaired Breathing Control in Multiple Sclerosis
Chest, June 1, 1999; 115(6): 1539 - 1545.
[Abstract] [Full Text] [PDF]

Home page
 J. Neurol. Neurosurg. PsychiatryHome page
R S Howard, J Thorpe, R Barker, T Revesz, N Hirsch, D Miller, and A J Williams
Respiratory insufficiency due to high anterior cervical cord infarction
J. Neurol. Neurosurg. Psychiatry, March 1, 1998; 64(3): 358 - 361.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.