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NEUROLOGY 1996;46:1160-1162
© 1996 American Academy of Neurology

Central neurogenic hyperventilation in an awake patient with a pontine glioma

A. D. Siderowf, MD, L. J. Balcer, MD, L.C. Kenyon, MD, PhD, M. Nei, MD, E. C. Raps, MD and S. L. Galetta, MD

From the Departments of Neurology (Drs. Siderowf, Balcer, Nei, Raps, and Galetta) and Pathology (Dr. Kenyon), Hospital of the University of Pennsylvania, Philadelphia.
Received August 18, 1995. Accepted in final form September 7, 1995.
Address correspondence and reprint requests to Dr Galetta, Department of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104.

A 57-year-old awake man developed central neurogenic hyperventilation associated with a pontine mass. Serum pH reached as high as 7.72 with serum carbon dioxide of 6 torr. Examination of CSF during overbreathing showed that CSF pH was markedly alkaline. Pathologic study showed a well-differentiated pontine astrocytoma. The combination of alkaline CSF and an infiltrating pontine lesion supports a structural, rather than chemical, mechanism for central hyperventilation.

NEUROLOGY 1996;46: 1160-1162




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