may present to the neurologist either as a precise description of a prolonged
respiratory pause in a neonate being monitored in the intensive care unit
or as an imprecise description of a life-threatening episode. These presentations
usually trigger a series of steps aimed at treating the apnea and finding
its cause. These steps include: (1) close monitoring, (2) increased level
of readiness to provide respiratory support, (3) clinical and laboratory
investigations to determine the cause of apnea, and sometimes, (4) empirical
or specific treatment to eliminate or correct the cause of apnea based
on the results from the initial clinical and laboratory investigations.
Figure 13.1.— Neurological structures involved in normal breathing. A: midbrain; B: pons; C: medulla; D: cervical spine; 1: chemoreceptor; 2: dorsal respiratory group at the nucleus of the tractus solitarious; 3: ventral respiratory group at the nucleus ambiguus and nucleus retroambigualis; 4: upper airway motor neurons; 5: upper airway motor muscles; 6: phrenic center; 7: diaphragm; 8: intercostal muscle anterior horn cells; 9: intercostal muscles.