Chronic dyspnea and hyperventilation in an awake patient with small subcortical infarcts.
A 79-year-old woman presented with chronic dyspnea and hyperventilation. There was no evidence of pulmonary disease. Hyperventilation persisted during sleep and after high-dose administration of a narcotic. A head MRI revealed bilateral medial thalamic infarctions. Central neurogenic hyperventilation was diagnosed in this alert patient. The case may illustrate a role for the thalamus in regulating ventilation, but another small infarct not visible on MRI also could be responsible.
Johnston
S C
SC
Neurovascular Service, Department of Neurology, University of California, San Francisco, CA 94143-0114, USA. clayj@itsa.ucsf.edu
Singh
V
V
Ralston
H J
HJ
Gold
W M
WM
D000368:Aged; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000503:physiopathology; D003937:Diagnosis, Differential; D004292:Dominance, Cerebral / Q000502:physiology; D004417:Dyspnea / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006985:Hyperventilation / Q000209:etiology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D013786:Thalamic Diseases / Q000175:diagnosis* / Q000503:physiopathology; D013788:Thalamus / Q000503:physiopathology; D014851:Wakefulness / Q000502:physiology