PEDIATRICS Vol. 83 No. 2 February 1989, pp. 250-255
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Nocturnal Hypoventilation in Children With Nonprogressive Neuromuscular Disease

J. Z. Heckmatt MD, MRCP1, L. Loh FFARCS1, and V. Dubowitz MD, PhD, FRCP1

1 The Department of Paediatrics and Jerry Lewis Muscle Research Centre, Royal Postgraduate Medical School, Hammersmith Hospital, and Department of Anaesthetics, The National Hospital for Nervous Diseases, London

Eight patients between 4 and 24 years of age with nonprogressive neuromuscular disease sought medical attention because of severe nocturnal hypoventilation. There were two types of findings: subacute with progressive early morning headaches and daytime drowsiness and acute with ventilatory failure and cor pulmonale. Seven patients were ambulant. Seven were successfully treated with either a cuirass negative pressure ventilator or a positive pressure ventilator via a tracheostomy. The ventilatory assistance was only used at night and resulted in rapid resolution of early morning symptoms and a return to full daytime activity. One patient died as a result of an intercurrent respiratory infection before respiratory support could be given. It is important to be aware of this potentially life-threatening complication in patients with an otherwise good prognosis and of the benefit to be derived from active treatment.

Key Words: nocturnal hypoventilation • nonprogressive neuromuscular disease

Submitted on July 28, 1987
Accepted on February 23, 1988




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