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Neurology 2001;57:2131-2133
© 2001 American Academy of Neurology
Brief Communications

Chronic dyspnea and hyperventilation in an awake patient with small subcortical infarcts

S. Claiborne Johnston, MD, PhD;, Vineeta Singh, MD;, Henry J. Ralston, III, MD and Warren M. Gold, MD

From the Neurovascular Service, Department of Neurology (Drs. Claiborne Johnston and Singh), and Department of Medicine (Dr. Gold), University of California, San Francisco.

Address correspondence and reprint requests to Dr. S. Claiborne Johnston, Department of Neurology, Box 0114, University of California, San Francisco, 505 Parnassus Avenue, M-798, San Francisco, CA 94143-0114; e-mail: clayj{at}itsa.ucsf.edu

Article abstract—— 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.




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