pontine tegmentum leads to a disruption of cortical inhibitory effects of medullar respiratory center. plum and swanson suggested that failure to inhibit the activity of this particular region of the brain results in continuous stimulation of the respiratory center by the lateral pontile reticular formulation and laterally located descending neural pathway. the destruction of this required negative feedback mechanism causes the uncontrollable hyperventilation associated with cnh. additional findings subsequent findings revealed cnh can also occur in conscious patients. patients with tumor-induced cnh remain conscious because the reticular activating system of the brain is not affected by the tumor in the early stages of the condition. the condition is considered extremely uncommon, and only 21 additional cases of tumor-inducing cnh were reported up until 2005. only five of these cases were reported in children. the causes associated with conscious cnh are more varied than originally predicted by plum and swanson's study of comatose patients, although the most commonly reported causes of cnh involve infiltrative gliomas and lymphomas of the brainstem and pons. although the majority of cnh-inducing tumors are located in close proximity to other medullary homeostatic centers, the physiological changes associated with cnh are restricted to alterations in the control of breathing. most patients present with normal readings for heart rate and blood pressure, even in the case of severe alkalosis caused by cnh, which indicates that the respiratory center affected by cnh is more sensitive to compression than other areas of the brain. research current mechanisms by which cnh functions still remain poorly developed. in addition, a standard form of treatment has not been established to treat cnh. these characteristics make cnh an important condition that still needs to be investigated in adults and children, though the extreme rarity of the condition makes it difficult for research to successfully examine clinical cases.