Severe Cheyne-Stokes Respiration In An Awake Patient After Stroke

Cheyne-Stokes respiration (CSR), a disorder characterised by recurrent central apnoeas alternating with a crescendodecrescendo pattern of tidal volume, is relatively frequent in conscious patients after stroke. However, this respiratory disorder is, in general, not clinically detected probably due to slight intensity and scant clinical consequence. We report the case of a 70year-old-woman who experienced severe CSR after a stroke with severe desaturation during the apnoeic periods. Treatment with oxygen, continuous positive airways pressure and noninvasive ventilation was unsuccessful. With pharmacological therapy (acetazolamide, medroxyprogresterone and theophylline) the CSR resolved.