Dysarthria due to Loss of Voluntary Respiration

To the Editor.— The failure of voluntary respiration with preservation of automatic respiratory function is rare. Newsom Davis 1 described such a patient with acute demyelination. Dysarthria was present in his patient, but was not described in detail. We studied a case of dysarthria due to loss of voluntary respiration in a patient with multiple sclerosis Report of a Case.— A 32-year-old woman showed development of bilateral diminution of visual acuity with remission in 1975. There were several exacerbations and remissions of visual loss and paraparesis during the following four years. She became disabled and bedridden, but was not quadriplegic. On May 8, 1980, quadriplegia developed. The patient was alert and oriented. The neck and four limbs were completely paralyzed. The bulbar muscles were not involved. Spontaneous respiration was regular and 22/min. No artificial respiration was necessary, but she could neither take a voluntary breath nor stop breathing. Her voice