Abstract
We assessed central respiratory dysfunction in 7 patients with multipule system atrophy (MSA; 2 MSA-C and 5 MSA-P). Four patients with MSA-P had been performed the tracheostomy because of vocal cord abduction paralysis and pneumonia. The respiration pattern of waxing and waning was observed in 2 no-tracheostomised patients, and Cheyne-Stokes respiration (CSR) in 3 tracheostomised MSA-P patients. A no-tracheostomised MSA-P patient showed both obstructive respiration and CSR. Another tracheostomised patient needed the respirator for the insufficient autonomic respiration. There was a positive ventilatory response to hyperoxic carbon dioxide rebreathing test in all tracheostomised patients, and 2 of those patients showed the pattern of the facilitation followed by the depression. The voluntary respiration control was impaired in all advanced MSA-P patients. MSA disclosed the central respiratory disorder caused by not merely the hypof unction of the central respiratory neuron but also that of the pyramidal and extrapyramidal systems.
