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Frederick E. Munschauer, MD; M. Jeffery Mador, MD; Arvind Ahuja, MD; Lawrence Jacobs, MD

Arch Neurol. 1991;48(11):1190-1192.

Abstract
• We describe a patient in whom a discrete infarction of the ventral basis pontis caused a complete loss of voluntary respiration, while automatic respiration remained intact. Respiratory excursions, quantified title volumes, and ventilatory response to carbon dioxide were normal, but the patient could not volitionally modify any respiratory parameters. Emotional stimuli producing laughter, crying, or anxiety appropriately modulated automatic respiration. This case established that pathways subserving limbic modulation of automatic respiration descend in the pontine tegmentum and/or lateral portion of the basis pontis spared by this lesion. Furthermore, descending limbic influences on automatic respiration are anatomically and functionally independent of the voluntary respiratory system.

Author Affiliations
From the Department of Neurology (Drs Munschauer and Jacobs), the Division of Pulmonary and Critical Care Medicine (Drs Munschauer and Mador), and the Department of Neurosurgery (Dr Ahuja), State University of New York at Buffalo.

Footnotes
Accepted for publication June 10, 1991.

Reprint requests to Department of Neurology, Buffalo General Hospital, 100 High St, Buffalo, NY 14203 (Dr Munschauer).

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