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Respiratory inhibitory apraxia.

E A Atack, L Suranyi

    The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
    |February 1, 1975
    PubMed
    Summary
    This summary is machine-generated.

    Researchers identified a new condition, respiratory inhibitory apraxia (R.I.A.), where patients cannot voluntarily stop breathing. This inability is linked to specific brain lesions, suggesting a novel neurological disorder affecting respiratory control.

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    Area of Science:

    • Neurology
    • Respiratory Medicine
    • Neuroscience

    Background:

    • Voluntary control over respiration is crucial for various functions.
    • Involuntary breathing mechanisms are distinct from voluntary respiratory control.
    • Previous literature lacks a defined condition for the inability to voluntarily inhibit breathing.

    Purpose of the Study:

    • To describe a newly identified neurological disorder: respiratory inhibitory apraxia (R.I.A.).
    • To investigate the clinical characteristics and potential underlying pathophysiology of R.I.A.
    • To explore associations between R.I.A. and other neurological deficits.

    Main Methods:

    • Clinical observation and description of ten patients presenting with inability to stop breathing on command.
    • Review of respiratory system anatomy and voluntary control mechanisms.

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  • Neurological examination and assessment for associated motor or inhibitory deficits.
  • Detailed neuropathological examination of one autopsied case.
  • Main Results:

    • Ten patients exhibited a consistent inability to voluntarily cease respiration, while spontaneous and stimulated breathing remained unaffected.
    • Respiratory inhibitory apraxia (R.I.A.) was observed to co-occur with other forms of apraxia and motor impersistence in some patients.
    • Urinary and bowel incontinence were noted in some cases, potentially representing a related inhibitory apraxia.
    • The autopsied case revealed a deep-seated lesion in the internal capsule affecting descending motor pathways, disconnecting the cortical respiratory inhibitory center.

    Conclusions:

    • Respiratory inhibitory apraxia (R.I.A.) is a distinct neurological condition characterized by the inability to voluntarily inhibit breathing.
    • R.I.A. is likely associated with lesions in the minor (typically left) cerebral hemisphere, often affecting deep structures.
    • The findings suggest that R.I.A. results from a disconnection between voluntary respiratory control centers and the descending motor pathways.