Cases reported "Poliomyelitis"

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1/3. A case of frog breathing.

    Frog breathing (glossopharyngeal breathing) is a useful technique employed to increase ventilation when respiratory muscles are paralysed. It is a technique used by many patients with chronic poliomyelitis, yet many chest physicians and physiotherapists are unfamiliar with this breathing maneuver. Glossopharyngeal breathing coordinates movements of the tongue, cheeks and pharynx to force air from the mouth into the lungs. We report a case of glossopharyngeal breathing, demonstrating a 3 fold increase in vital capacity in a subject with chronic poliomyelitis.
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2/3. speech production with flaccid paralysis of the rib cage, diaphragm, and abdomen.

    Anteroposterior diameter changes of the rib cage and abdomen were measured during breathing maneuvers and utterance activities in an adult subject with flaccid paralysis of the rib cage, diaphragm, and abdomen. Data were charted to solve for lung volume, volumes of the rib cage and abdomen, chest wall configuration, and inferred neck muscle actions. Free breathing was accomplished through an alternate waxing and waning of neck muscle drive or through step-wise glossopharyngeal pumping. Connected speech was performed in breath groups begun by neck gestures that "cocked" the breathing apparatus and stored recoil energy in it for use during ensuing expirations. Some breath groups were also extended through intermittent glossopharyngeal pumping. Connected speech was characterized by frugal control of the air supply through compensatory adjustments in the larynx and upper airway. Compensations involved in the breathing maneuvers and utterance activities are described, and consideration is given to two understandings--the human potential for functional restoration and the clinical evaluation and management of individuals with neuromuscular impairment.
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keywords = breathing
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3/3. sleep apnea syndrome after poliomyelitis.

    We present a case of severe breathing abnormality during sleep in a young man who had had poliomyelitis 20 yr before. His sleep disorder led to respiratory failure and cor pulmonale, which were greatly improved by oxygen therapy. A study of this case and those previously described supports the notion that brainstem damage during acute poliomyelitis is important in the later appearance of sleep-disordered breathing. In addition, such patients usually have mechanical abnormalities involving the thoracic cage and respiratory muscles. These ventilatory restrictions amplify the pathophysiologic effects of abnormal central nervous system control of breathing during sleep, and we suggest that their presence has a key role in the development of sleep apnea syndrome in these patients.
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keywords = breathing
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