Biot's breathing

Neurological disease may affect breathing cycles and rhythms. ¹ Several classic central periodic breathing patterns have been described. Biot's breathing-also known as ataxic breathing-is a breathing pattern in patients with acute neurological disease, but is rarely mentioned in the neurological literature. It can be contrasted with Cheyne-Stokes breathing (periodic stereotypical crescendo-decrescendo hyperpnoea followed by apnoea) and apneustic breathing (periodic prolonged inspiratory hold). Biot's breathing may be a rare phenomenon or just not noticed. Biot's contribution is discussed here.

WHO WAS BIOT?

Camille Biot was born in Chatenoy-le-Royal (Saône-et-Loire), France, on 19 December 1850. He made his seminal observations while an intern in the Hôtel Dieu Hospital in Lyon, France. After his residency, he practised medicine in Macon in 1875. He wrote on other diverse medical topics unrelated to breathing, as well as articles about Greco-Roman-Maconne archeology. He became a member of L'Académie de Macon (Société des arts, sciences, belles lettres archeology, agriculture et encouragement au bien de Saône-et-Loire, fig 1). He died in Macon in 1918. ²

Dr Camille Biot.

WHAT WAS BIOT'S CONTRIBUTION?

Biot wrote two main articles on breathing patterns. One large exploratory work focused on his observations on Cheyne-Stokes breathing.), and he was one of the first to publish recordings of this type of respiration in a 16-year-old patient with tuberculous meningitis (fig 3). He distinguished this breathing pattern from Cheyne-Stokes breathing and named it "rhythme meningitique". The breathing pattern is irregular and rapid, with rhythmical pauses lasting 10-30 s, but sometimes with alternating periods of apnoea and tachypnoea. This breathing pattern lacked the crescendo-decrescendo cycles attributed to Cheyne-Stokes breathing and was completely irregular with varying periods of apnoea. In 1878, a larger thesis was published entitled: Étude de Clinique et expérimentale sur la respiration de Cheyne-Stokes . ⁴ This paper described theories of the origins of Cheyne-Stokes breathing. Biot argued that Cheyne-Stokes breathing included an increase in pulse during the pause and reduction of blood pressure during apnoea. In this now discounted theory, the accumulation of carbon dioxide would increase the activity of the vasomotor centre and vasoconstriction would cause progressive ischaemia of the respiration centre resulting in deep breaths.

The first description of a breathing pattern different from Cheyne-Stokes breathing. Translation: "We stated in the previous pages that the various...