Pacing of the diaphragm to control breathing in patients with paralysis of central nervous system origin.

Thirty-five patients, 21 males and 14 females, aged 2-69 years (mean 25 years) with partial or total respiratory paralysis due to high cervical cord lesions, brain stem lesions, or central hypoventilation syndrome (sleep apnoea, 'Ondine's curse'), received phrenic nerve stimulators for pacing of the diaphragm. At a mean follow-up time of 46 months (range 2 months to 10 years) 15 patients are entirely independent of respirator and 8 quadriplegics ventilate with pacers at different daytime intervals and use mechanical ventilators during the night. Five patients have stopped pacing and 7 additional cases have died of causes unrelated to electrophrenic stimulation.