Headaches, opiates and kyphoscoliosis--a dangerous mixture

Acute respiratory failure is a recognised complication of kyphoscoliosis, but such individuals exhibit a wide range of cardiorespiratory dysfunction ranging from clinically insignificant disease to severe respiratory failure and eventual death. We report a 49 year old lady with adolescent kyphoscoliosis who presented to her general practitioner with nocturnal headaches of such severity that opiates were given pending transfer to hospital over a distance of 50 miles. This induced acute respiratory failure for which assisted ventilation was required.