Multiple neurological and muscular diseases can manifest with compromised respiratory function and even respiratory failure due to ventilatory muscle weakness. Neuromuscular respiratory failure is characterized by weakness in the respiratory muscles, hypoxemia, dyspnea, dysphagia, nonproductive cough, and fatigue. Other findings include headache, atelectasis, muscle atrophy, dysphonia, insomnia, stridor, tachycardia, tachypnea, bradypnea, and cyanosis. The presentation varies depending on the underlying cause. This can affect all ages. 

Underlying neurologic conditions include Guillain-Barré syndrome (ie, acute motor axonal neuropathy, acute inflammatory demyelinating polyneuropathy), myasthenia gravis, amyotrophic lateral sclerosis, critical illness neuromyopathy, cerebral ischemia, glycogen storage diseases, multiple sclerosis, Huntington disease, Parkinson disease, syringomyelia, transverse myelitis, and polymyositis. 

Guillain-Barré syndrome typically presents with ascending weakness. Botulism presents with rapidly descending paralysis and autonomic dysfunction. Myasthenia gravis often has fluctuations and fatigability of muscle weakness. 

Recent infections or changes in medications can potentially precipitate the weakness. 

Diagnosis of the underlying disease can guide treatment to alleviate symptoms. Guillain-Barré syndrome, myasthenia gravis, and critical illness neuromyopathy are the most common causes for acute neuromuscular respiratory failure.