1 Neurosurgery and Pediatrics, University of California Medical Center, San Diego, CA
To the Editor.
The findings by the authors of a recent report about abnormalities in hypoxic and hypercapnic arousal responses in children with myelomeningocele and Arnold-Chiari malformation, who were symptomatic with apnea and/or hyperventilation, are interesting indeed, and the abnormalities have been reported well.1
In the discussion, the authors failed to tell the readers about the known anatomical substrate for such abnormalities. The anatomical substrate is a malformation of brainstem nuclei and consequently brainstem connections of the cranial nerve nuclei and reticular formation.