Mechanisms of “central” hyperventilation

The imaginatively and carefully studied patient described by Rodriguez et a1 in this issue of the Annals 171 undoubtedly demonstrates the phenomenon of sustained physiological hyperventilation caused by a lower brainstem lesion. It seems possible, however, that the observed breathing abnormaiity may have been a result of the metabolic effects of the neoplasm rather than being due to neoplastic destruction of putative lower brainstem structures that theoretically would normally damp an otherwise unchecked pattern of overbreathing.