Chronic
hypoventilation due to injury to the brain stem respiratory center or high cervical cord (above the C3 level) can result in dependence to prolonged
mechanical ventilation with
tracheostomy, frequent
nosocomial pneumonia, and prolonged hospitalization. Diaphragm pacing through electrical stimulation of the phrenic nerve is an established treatment for central
hypoventilation syndrome. We performed chronic phrenic nerve stimulation for diaphragm pacing with the spinal cord stimulator for
pain control in a quadriplegic patient with
central apnea due to complete
spinal cord injury at the level of C2 from cervical epidural
hematoma. After diaphragmatic pacing, the patient who was completely dependent on the
mechanical ventilator could ambulate up to three hours every day without aid of
mechanical ventilation during the 12 months of follow-up. Diaphragm pacing through unilateral phrenic nerve stimulation with spinal cord stimulator was feasible in an apneic patient with complete
quadriplegia who was completely dependent on
mechanical ventilation. Diaphragm pacing with the spinal cord stimulator is feasible and effective for the treatment of the central
hypoventilation syndrome.