Primary Alveolar Hypoventilation Associated with Western Equine Encephalitis
Authors: JEROME E. COHN
Journal: Annals of Internal Medicine (1962)

Case Reports1 April 1962Primary Alveolar Hypoventilation Associated with Western Equine EncephalitisJEROME E. COHN, M.D., HIROSHI KUIDA, M.D.JEROME E. COHN, M.D., HIROSHI KUIDA, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-56-4-633 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe alveolar hypoventilation syndrome, characterized by arterial hypercapnia, develops when alveolar ventilation falls below a critical value. Fishman, Turino, and Bergofsky reviewed the clinical, pathophysiological, and biochemical features of the syndrome and many of the disease processes with which it may be associated (1). Usually hypoventilation occurs secondary to dysfunction of the lung, thoracic bellows, or motor nerves. "Primary alveolar hypoventilation," a rare condition, is ascribed to diminished responsiveness of the respiratory center itself (Table 1). This diagnosis can be made only when hypoventilation occurs in the absence of functional abnormality of the lungs, chest muscles, and motor nerves. Rodman...References1. FISHMANTURINOBERGOFSKY APGMEH: The syndrome of alveolar hypoventilation. Amer. J. Med. 23: 333, 1957. CrossrefMedlineGoogle Scholar2. RODMANCLOSE THP: The primary hypoventilation syndrome. Amer. J. Med. 26: 808, 1959. CrossrefMedlineGoogle Scholar3. GARLINDLINDERHOLM TH: Hypoventilation syndrome in a case of chronic epidemic encephalitis. Acta Med. Scand. 162: 333, 1958. CrossrefMedlineGoogle Scholar4. MULDERPARROTTTHALER DWMAM: Sequelae of Western equine encephalitis. Neurology 1: 318, 1951. CrossrefMedlineGoogle Scholar5. FINLEY K: Viral encephalomyelitis. Med. Clin. N. Amer. 43: 1465, 1959. CrossrefMedlineGoogle Scholar6. EKLUND C: Human encephalitis of western equine type in Minnesota in 1941. Clinical and epidemiological study of serologically positive cases. Amer. J. Hygiene 34: 171, 1946. Google Scholar7. HAMMAN WM: The epidemic encephalitides of North America. Med. Clin. N. Amer. 27: 632, 1943. CrossrefGoogle Scholar8. FINLEYCHAPMAN KHWM: The 1952 outbreak of encephalitis in California—long term neurologic and pychiatric studies of sequelae. Calif. Med. 79: 94, 1953. MedlineGoogle Scholar9. FINLEY KH: Postencephalitis manifestations of viral encephalitides, in Viral Encephalitis, ed. by Fields, W. S., and Blattner, R. J., Charles C Thomas, Springfield, Ill., 1958, pp. 69-94. Google Scholar10. LENNETTELONGSHORE EHWA: Western equine and St. Louis encephalitis in man in California, 1945-1950. Calif. Med. 75: 189, 1951. MedlineGoogle Scholar11. KORYCALLAHANBORENSYNER RCRHCJC: The Veterans Administration-Army cooperative study of pulmonary function. Amer. J. Med. 30: 243, 1961. CrossrefMedlineGoogle Scholar12. COMROEFORSTERDUBOISBRISCOECARLSEN JHREAWE: The Lung: Clinical Physiology and Pulmonary Function Tests, The Year Book Publishers, Inc., Chicago, 1955. Google Scholar13. COMROEFOWLER JHWS: Lung function studies. VI. Detection of uneven alveolar ventilation during a single breath of oxygen. Amer. J. Med. 10: 408, 1951. CrossrefMedlineGoogle Scholar14. MEADWHITTENBERCER JJL: Physical properties of human lungs measured during spontaneous respiration. J. Appl. Physiol. 5: 779, 1953. CrossrefGoogle Scholar15. FRANKMEADSIEBENSSTOREY NRJAACF: Measurements of pulmonary compliance in seventy healthy young adults. J. Appl. Physiol. 9: 38, 1956. CrossrefMedlineGoogle Scholar16. CLEMENTSSHARPJOHNSONELAM JAJTRPJO: Estimation of pulmonary resistance by repetitive interruption of airflow. J. Clin. Invest. 38: 1262, 1959. CrossrefMedlineGoogle Scholar17. CHENGGODFREYSHEPARD TOMPRH: Pulmonary resistance and state of inflation of lungs in normal subjects and in patients with airway obstruction. J. Appl. Physiol. 14: 727, 1959. CrossrefGoogle Scholar18. SCHOLANDER PF: Analyzer for accurate estimation of respiratory gases in one-half cubic centimeter samples. J. Biol. Chem. 167: 235, 1947. CrossrefMedlineGoogle Scholar19. RILEYCAMPBELLSHEPARD RLEJRH: A bubble method for estimation of PCO2 and PO2 in whole blood. J. Appl. Physiol. 11: 245, 1957. CrossrefMedlineGoogle Scholar20. VAN SLYKENEILL DJM: The determination of gases in blood and other solutions by vacuum extraction and manometric measurement. J. Biol. Chem. 61: 523, 1924. CrossrefGoogle Scholar21. WINTROBE MM: Clinical Hematology, 4th ed., Lea & Febiger, Philadelphia, 1956. Google Scholar22. LILLENTHALRILEYPROEMMELFRANKE JLRLDDRE: An experimental analysis in man of the oxygen pressure gradient from alveolar air to arterial blood. Amer. J. Physiol. 147: 199, 1946. CrossrefMedlineGoogle Scholar23. RILEYCOURNAND RLAC: Analysis of factors affecting the concentration of oxygen and carbon dioxide in the gas and blood of the lung. I. Theory. J. Appl. Physiol. 2: 77, 1951. CrossrefGoogle Scholar24. RILEYDONALDCOURNAND RLKWAC: Analysis of factors affecting the concentration of oxygen and carbon dioxide in the gas and blood of the lung. II. Methods. J. Appl. Physiol. 2: 102, 1951. CrossrefGoogle Scholar25. SINGERHASTINGS RBAB: An improved clinical method for estimation of disturbances of the acid-base balance of human blood. Medicine 27: 223, 1948. CrossrefMedlineGoogle Scholar26. HEERHABERLOESCHKEWESTPHAL IHHV: Eine Wirkung des Progesterone auf die Atmung. Arch. Ges. Physiol. 250: 42, 1948. CrossrefGoogle Scholar27. LANDAUBERGENSTALLUGIBIKEKASCHT RLDMKME: Metabolic effects of progesterone in man. J. Clin. Endocr. 15: 1194, 1955. CrossrefGoogle Scholar28. CULLENBRUMREIDT JHVCWW: The respiratory effects of progesterone in severe pulmonary emphysema. Amer. J. Med. 27: 551, 1959. CrossrefMedlineGoogle Scholar29. TYLER JM: The effect of progesterone on respiration of patients with emphysema and hypercapnia. J. Clin. Invest. 39: 34, 1960. CrossrefMedlineGoogle Scholar30. TYLER JM: The effect of progesterone on respiration of patients with emphysema and hypercapnia. Clin. Res. Proc. 5: 229, 1957. Google Scholar31. JENKINSDONATH AAR: The 1958 encephalitis outbreak in northern Utah. I. Human aspects. Mosquito News 19: 221, 1959. Google Scholar32. GRAY JS: Pulmonary ventilation and its physiological regulation. Charles C Thomas, Springfield, Ill., 1950. Google Scholar33. GRODINSGRAYSCHROEDERNORINSJONES FSJSKRALRW: Respiratory responses to CO2 inhalation. A theoretical study of a nonlinear biological regulator. J. Appl. Physiol. 7: 283, 1955. CrossrefGoogle Scholar34. BELLVILLESEED JWJC: The use of an analog computer for measurement of respiratory depression. Trans. N.Y. Acad. Sci. 22: 34, 1959. CrossrefGoogle Scholar35. ASTROM A: On the action of combined carbon dioxide excess and oxygen deficiency in the regulation of breathing. Acta Physiol. Scand. (Supp. 98) 27: 1, 1952. MedlineGoogle Scholar36. ALEXANDERWESTWOODRICHARDS JKJRJADN: Analysis of the respiratory responses to carbon dioxide inhalations in varying clinical states of hypercapnia, anoxia and acid-base derangement. J. Clin. Invest. 34: 511, 1955. CrossrefMedlineGoogle Scholar37. BEDELLROSENBERG GNRS: An evaluation of the respiratory response to breathing 7.5% CO2 in air as a test of respiratory center depression. Fed. Proc. 19: 379, 1960. Google Scholar38. RATTOBRISCOEMORTONCOMROE OWAJJH: Anoxemia secondary to polycythemia and polycythemia secondary to anoxemia. Amer. J. Med. 19: 958, 1955. CrossrefMedlineGoogle Scholar39. RICHTERWESTFISHMAN TJRAP: The syndrome of alveolar hypoventilation and diminished sensitivity of the respiratory center. New Engl. J. Med. 256: 1165, 1957. CrossrefMedlineGoogle Scholar40. PARELOWENSTEIN PL: Polycythemia associated with disturbed function of the respiratory center. Blood 11: 1077, 1956. CrossrefMedlineGoogle Scholar41. LAWRENCE IT: Idiopathic hypoventilation, polycythemia and cor pulmonale. Amer. Rev. Resp. Dis. 80: 575, 1959. MedlineGoogle Scholar42. . Hypoventilation syndrome. Ed. by Smith, L. H. Amer. Practit. 7: 1165, 1956. Google Scholar43. FOWLER NO: Effects of pharmacological agents on the pulmonary circulation. Amer. J. Med. 28: 927, 1960. CrossrefGoogle Scholar44. BURTON AC: The relation between pressure and flow in the pulmonary bed, in Pulmonary Circulation, ed. by Adams, W. R., and Veith, I., Grune & Stratton, Inc., New York, 1959, pp. 26-32. Google Scholar45. EDWARDS WS: The effects of lung inflation and epinephrine on pulmonary vascular resistance. Amer. J. Physiol. 167: 756, 1951. CrossrefMedlineGoogle Scholar46. WILLIAMS MH: Relationships between pulmonary artery pressure and blood flow in the dog lung. Amer. J. Physiol. 179: 243, 1954. CrossrefMedlineGoogle Scholar47. CARLILLDUKEJONES SDHNM: Some observations on pulmonary hemodynamics in the cat. J. Physiol. 136: 112, 1957. CrossrefMedlineGoogle Scholar48. NAHASCAVERT CGMH: Cardiac depressant effect of CO2 and its reversal. Amer. J. Physiol. 190: 483, 1957. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JEROME E. COHN, M.D.; HIROSHI KUIDA, M.D.Affiliations: Salt Lake City, UtahFrom the Department of Internal Medicine, University of Utah College of Medicine, and Veterans Administration Hospital, Salt Lake City, Utah.Supported in part by United States Public Health Service Grant B-1220.Requests for reprints should be addressed to Jerome E. Cohn, M.D., Medical Center, University of Kentucky, Lexington, Ky. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySequelae and Animal Modeling of Encephalitic Alphavirus InfectionsNeurogenic control of respirationMouse Model of Neurological Complications Resulting from Encephalitic Alphavirus InfectionSleep, Breathing, and Neurologic DisordersNeurological Sequelae Resulting from Encephalitic Alphavirus InfectionCentral Sleep ApneaThe First Descriptions of Clinical SignsSueño, respiración y trastornos neurológicosCentral Sleep ApneaSleep, Breathing, and Neurologic DisordersSudden Death Due to Central Alveolar Hypoventilation Syndrome (Ondine's Curse) in a 39-Year-Old Woman With Heterotopia of the Inferior OliveRespiratory Control and Respiratory Sensation in a Patient with a Ganglioglioma within the Dorsocaudal Brain StemNeurologic Causes of Acute Respiratory DysfunctionNeurologic Causes of Acute Respiratory DysfunctionNeuroborreliosis as a cause of respiratory failureCentral alveolar hypoventilation associated with paraneoplastic brain-stem encephalitis and anti-Hu antibodiesSleep, Breathing, and Neurological DisordersRespiratory failure and unilateral caudal brainstem infarctionAcquired Ondine's CurseEvaluation of Respiratory Disorders During SleepHyperventilation and panic disorderNeurogenic hypoventilation caused by an enlarged fourth ventricleLiteraturverzeichnisPRIMARY ALVEOLAR HYPOVENTILATIONDiaphragm Pacing: Present Status*Kleine-Levin syndrome with periodic apnea during hypersomnic stages — E.E.G. studyThe Aetiology of the Sudden Infant Death Syndrome: Current Ideas on Breathing and Sleep and Possible Links to Deranged Thiamine NeurochemistryA Simple Technique for the Determination of the Ventilatory Response to Rising Arterial CO 2 Tensions, Suitable for Patients with Neurological DisordersDas prim�re HypoventilationssyndromSleep, Periodic Breathing and Snoring in the Aged: Control of Ventilation in the Aging and Diseased Respiratory System*Congenital failure of automatic ventilation (Ondine's curse)Differential Diagnosis of Chronic Respiratory InsufficiencyAtemregulation bei Barbituratvergiftung und bei Cor pulmonaleIdiopathic Central HypoventilationFurther Observations on the Effect of Hydrogen Ion on the Pulmonary CirculationCorrectionA Physiological Classification of Cor PulmonaleALVEOLAR HYPOVENTILATION WITH NORMAL LUNGS: THE SYNDROME OF PRIMARY OR CENTRAL ALVEOLAR HYPOVENTILATION *Schlafstörungen und Pickwick-Syndrom 1 April 1962Volume 56, Issue 4Page: 633-644KeywordsEncephalitisHospital medicineHypercapniaInhalationLungsMedical servicesMusclesNervesSaltsThorax ePublished: 1 December 2008 Issue Published: 1 April 1962 PDF downloadLoading ...