Diaphragmatic pacing for neurogenic respiratory failure in neuromyelitis optica spectrum disorder: A case series

Diaphragmatic pacing (DP) has not been well-studied in adults with central respiratory failure secondary to inflammatory disorders of the brain and spinal cord. We present two novel cases of DP in the treatment of respiratory failure secondary to brainstem and high cervical spinal cord lesions in neuromyelitis optica spectrum disorder patients. In case 1, DP facilitated tracheostomy reversal and the patient was successfully weaned from DP. In case 2, DP helped improve chronic hypercapnia and the frequency of apneic events. Early initiation of DP should be considered in this patient population to treat central hypoventilation and central sleep apnea.