What is the primary cause of seesaw breathing in children with neuromuscular disease?

Seesaw breathing, also known as paradoxical breathing, occurs when there is a disruption in the normal mechanics of breathing. In children with neuromuscular disease, the primary cause of seesaw breathing is the weakness of abdominal and chest wall muscles. This muscle weakness prevents the child from maintaining proper respiratory mechanics, leading to the abdomen and chest moving in opposite directions during inhalation and exhalation.

When the diaphragm and accessory muscles of respiration are not functioning effectively due to neuromuscular impairment, the chest may move inward while the abdomen expands during inspiration, resulting in the seesaw pattern. This can be particularly problematic in neuromuscular diseases, where muscle strength is compromised.

Other conditions listed, such as obstructive sleep apnea or respiratory infections, may lead to abnormal breathing patterns, but they do not primarily cause seesaw breathing due to muscular dysfunction. Asthma exacerbation might cause wheezing and difficulty breathing, but does not typically result in the seesaw pattern that is characteristic of neuromuscular weakness.