II. Signs
- Alternating hyperpnea and apnea at regular intervals (30 second to 2 minute cycles)
- Smooth waxing and waning in depth of respiration
III. Pathophysiology
- Sites of Injury
- Bilateral Cerebral Hemisphere dysfunction or
- Diencephalon dysfunction (posterior forebrain structures including the Thalamus)
- Mechanism
- See Respiratory Physiology
- Hyperventilation with rapid and deep breathing results in hypocapnia (decreased pCO2)
- Decreased pCO2 suppresses respiration resulting in brief apnea
- Apnea results in rise in CO2 again, allowing for Hyperventilation and the cycle repeats itself
IV. Causes
- Cerebrovascular Accident
- Traumatic Brain Injury
- Intracranial Mass
- Congestive Heart Failure
- Metabolic encephalopathy
- Medications (e.g. Morphine)
- Carbon Monoxide Poisoning