the patient was alert and breathing spontaneously before the hyperventilation test, but loss of consciousness and apnea with spindle activity on eeg occurred when the end-tidal co2 decreased during the hyperventilation test. we herein report a patient with pha showing spindle activity on eeg in the hyperventilation test (hvt) and speculate on the pathophysiology of loc in pha. while she had been intubated on admission and was breathing spontaneously, we prepared a mechanical ventilator to ensure the patient’s safety in case of apnea during the hvt. three minutes later, the etco2 gradually increased to 38 mmhg, and she recovered consciousness and spontaneous breathing, with the disappearance of the spindle activity on eeg.
in our patient, when loc associated with pha occurred during the hvt, eeg revealed spindle activity, which disappeared in parallel with the recovery of consciousness and spontaneous breathing. in our patient, when loc and apnea occurred during the hvt, eeg revealed spindle activity, which disappeared in parallel with the recovery of consciousness and spontaneous breathing. spindle coma was described first in a patient with neoplasms of the hypothalamus and midbrain, sparing the thalamus (12). we herein report the case of a patient with pha showing spindle activity on eeg during the hvt. (b) eeg at the end of the hvt showing spindle activity.
this paper was done to demonstrate the clinical risk of post-hyperventilation apnea (pha) in patients with hvs. recently, the paper-bag method was not recommended for the treatment of patients with hvs [2]. the aim of this report is to demonstrate the development and clinical risk of pha with severe hypoxemia in patients with hvs. because of the frequent attacks she was referred to our hospital to undergo a regimen of psychotherapy and fasting therapy [14,15], which is effective for various stress-related diseases. therefore, the possibility of a hyperventilation attack being caused by other disorders was ruled out. simultaneously, cyanosis of the lips developed, and spo2 decreased to 70%. the course of pha in patient 2 is shown in figure 2. after a 30-minute hyperventilation attack, apnea persisted for two minutes, causing the lips to become cyanotic and spo2 to decrease to 72%. rr and length of pha were measured by a nurse, following the physician’s directions.
pha and bhs differ in the age of onset. pha has been reported to be due to a decreased paco2[3,19] and has been reported to be induced when paco2 was reduced to the threshold [20,21]. in addition, reduced vigilance after hyperventilation seems to be related to the appearance of pha according to mangin et al. the initial dose of diazepam administered to patient 2 was 5 mg (0.11 mg/kg), and a dose of 5 mg was added about 30 minutes later. therefore, diazepam should be chosen very carefully to prevent prolonged pha and cyanosis in the treatment of hyperventilation attacks related to hvs. it is desirable that a proper amount of oxygen be given to the patient, because hypoxemia is not good for the brain and hypoxemia at hypocapnia does not stimulate respiration. these problems were encountered with regard to the diagnosis of hvs and to the study of the mechanism and treatment of pha. x2 and x4 represent the time of the assisted ventilation by bag-mask.
hyperventilation syndrome (hvs) is characterized by functional hyperventilation attacks with no underlying organic abnormalities and generally carries a good after a 30-minute hyperventilation attack, apnea persisted for two minutes, causing the lips to become cyanotic and spo2 to decrease to 72%. the hyperventilation was severe enough to cause severe respiratory alkalosis, apnea and desaturation, which is a rare feature in emergence, related conditions, related conditions, related symptoms, why does apnea occurs after hyperventilation, alternating periods of hyperventilation and apnea.
suggested that apnea secondary to hyperventilation occurs because following the wash out of carbon dioxide from the body during hyperventilation an extended period of time is required for it to accumulate adequately enough to reach the threshold required to stimulate breathing [10]. generally, there are periods of alternating hyperventilation and apnea occurring while awake. the cause of these spells is unknown at this time. treatment with the myocardial vascular response to combined breathing maneuvers of hyperventilation followed by voluntary apnea is blunted in patients with given a diagnosis of behavioural hyperventilation-related csa, the treatment of central sleep apnea syndromes in adults: practice parameters with an, post hyperventilation apnea definition, hyperventilation sleep, hyperventilation causes, kussmaul breathing, which environmental factors control the breathing rate, central sleep apnea, when holding your breath what forces you to breathe, how does reading or concentration alter respiratory movements, why does rebreathing increase the respiratory rate, how many sounds can you hear between 2 successive pauses?.
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