Absent Hypoxic and Hypercapnic Arousal Responses in Children With Myelomeningocele and Apnea

Abstract

In Reply.— CNS anomalies associated with myelomeningocele and Arnold-Chiari malformation (Neurosurgery 1986;18:559-564) could account for the abnormal arousal responses we described (Pediatrics 1986;78:44-50). They may also explain the failure of posterior fossa decompression surgery to correct apnea in some patients with myelomeningocele. We were not able to study children before and after posterior fossa decompression surgery; nor did we examine postmortem specimens. Consequently, our paper does not determine whether the cause of abnormal arousal responses is due to mechanical compression or anatomical anomalies of the brainstem.