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Central Apnea


Question

My 28-month-old son has been diagnosed with central apnea. He has also had a seizure and was placed on anti-seizure medication. Will he outgrow the need for oxygen?

Answer of our experts

Central apnea is apnea (cessation of breathing) caused by something in the central nervous system repressing the drive for respiration. It is seen, for example, in premature infants, who often grow out of it. It should not cause a need for oxygen, although would cause saturations to drop when he is not breathing. I do not know what would be causing it in your son, unless he has a specific brain abnormality. Thus I could not predict whether or not he would grow out of it. If he has had a brain MRI or CT scan, another member of the SAC, Dr. Mark Kliewer, who is a radiologist, could review it and see if anything looks abnormal. Central apnea is not commonly seen in people with CdLS. Seizures are quite common, and most likely are unrelated. Theophylline can be used for central apnea as a stimulus for the brain to send the message to breathe. Caffeine is also sometimes used, although again this is mostly in premature infants. Reflux can potentially cause apnea if it is severe (from the pain of the acid going into the esophagus, the individual briefly cannot breathe), but that would not be considered central apnea. We have reason to believe that obstructive sleep apnea may be increased in CdLS, and a sleep study and ENT evaluation can be helpful for this.

TK 7-13-10

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Recommendation(s)

Autonomic nervous system

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Seizures in individuals with CdLS should be treated using the general management schemes.
R48
An MRI of the brain should be considered only if the individual with CdLS shows neurological signs other than microcephaly (smaller than normal head).

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