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Hyperventilation

Heat Tetany

Hyperventialtion is an abnormally increased pulmonary ventilation, leading to abnormal loss of carbon dioxide from the blood.


Presentation

  • Accurately diagnosing and treating adult patients presenting with recurrent syncope can be extremely problematic. We present the case of a patient who presented with recurrent syncope.[ncbi.nlm.nih.gov]
  • Of the nine children presenting solely with blank spells, further follow-up (mean duration 18mo, SD 21mo) revealed full resolution of symptoms in six, but three had persistent symptoms.[ncbi.nlm.nih.gov]
  • In addition to its antiepileptogenic activities, it results in inhibition of carbonic anhydrase isoenzymes II and IV, which are present in the central nervous system.[ncbi.nlm.nih.gov]
  • A young person presenting with shortness of breath is common to the accident and emergency department.[ncbi.nlm.nih.gov]
  • We present the case of a 10-year-old boy, Evan, where a knock to the head activated memories of past bullying, causing intense distress, activation of the body's stress-regulation systems and recurrent hospital presentations with hyperventilation-induced[ncbi.nlm.nih.gov]
Carpopedal Spasm
  • In extreme cases it may cause carpopedal spasms , a flapping and contraction of the hands and feet. [3] [4] Factors that may induce or sustain [2] hyperventilation include: physiological stress , anxiety or panic disorder , high altitude , head injury[en.wikipedia.org]
  • spasm Type 1 Excludes hysterical tetany ( F44.5 ) neonatal tetany ( P71.3 ) parathyroid tetany ( E20.9 ) post-thyroidectomy tetany ( E89.2 ) hyperpnea R06.4 hyperventilation R06.4 - see also Hyperventilation ICD-10-CM Codes Adjacent To R06.4 R06 Abnormalities[icd10data.com]
Muscle Twitch
  • If you are experiencing these symptoms, you may be chronically hyperventilating : dizziness & light-headedness breathlessness a sense of unreality increased and/or irregular heartbeat numbness, tingling, or cold in the hands and feet muscle twitching[overcomingyouranxiety.net]
  • , twitching and cramps, tension and panicky feelings, depression and anxiety.[healthnavigator.org.nz]
  • twitching Many different factors can cause chest symptoms with hyperventilation syndrome.[emedicinehealth.com]
Chvostek Sign
  • Chvostek's sign is also due to hypocalcaemia. Flick behind the ear, just in front of the mastoid bone where the facial nerve emerges. The hypersensitive facial nerve makes the muscles of the face twitch.[patient.info]
Leg Cramp
  • Cramps: - How to get rid of cramps : How to get rid of cramps breathing exercise - Leg cramps at night : Two easy solutions (Earthing and reduced breathing exercise).[normalbreathing.com]
Dizziness
  • Patients who complained of persistent dizziness were significantly more likely to have persistent HIN and high Korean Dizziness Handicap Inventory scores at the last follow-up compared with patients who did not suffer from dizziness.[ncbi.nlm.nih.gov]
  • Hyperventilation syndrome is one of the most common causes of dizziness in the general population, accounting for up to 25 percent of dizziness complaints. 1,2,7 Hyperventilation syndrome may present a diagnostic challenge to the chiropractic physician[dynamicchiropractic.com]
  • The symptoms of respiratory alkalosis include: dizziness, tingling in the lips, hands or feet, headache, weakness, fainting and seizures.[en.wikipedia.org]
  • 'Dizziness or light-headedness' was found to be more prevalent than 'fear of dying' by random-effects meta-analysis (68% vs. 23%). A proportion meta-analysis found a weighted occurrence of 20% of panic disorder in PNES.[ncbi.nlm.nih.gov]
  • The most common symptom was fear (586, 95.1%), followed by paraesthesia (379, 61.5%) and dizziness (306, 49.7%).[ncbi.nlm.nih.gov]
Paresthesia
  • He reported that paresthesias were occasionally asymmetrical and could even be unilateral.[medlink.com]
  • Side effects, including vertigo, paresthesias and muscle tremor, were present in 70% of the volunteers during hyperventilation with 100% O2, and these side effects forced them to limit their respiratory rates and tidal volumes.[ncbi.nlm.nih.gov]
  • The symptoms of acute hyperventilation are mainly caused by the hypocalcemia . 4 Symptoms Tachypnea Muscle spasms Paresthesia Dizziness Anxiety Spasms of the muscles of the lower arm and hands ( hyperventilation tetany ) can lead to the characteristic[flexikon.doccheck.com]
  • THE hyperventilation syndrome, as seen in anxious, tense persons, is characterized by paresthesia of the extremities and circumoral area, sensations of lightheadedness and altered consciousness and occasionally carpal spasm.[nejm.org]
  • […] containing a vasoconstrictor congruent with the patient’s functional capacity Signs and symptoms: Frequent ( 20 breaths/min), prolonged sighing inspiration Dyspnea Sometimes so severe that the patient feels like suffocating Light-headedness and dizziness Paresthesia[dentalcare.com]
Agitation
  • Clothing made of soft fibers (cotton, silk) may also be helpful, as rougher fabrics such as wool can cause skin irritation, discomfort, overheating and agitation in some people. 4 Try relaxation techniques.[wikihow.com]
  • After surgery, or illness, or prolonged social or physical stress Symptoms Acute Attack - agitation, rapid upper chest breathing and heart-rate, chest pains, shortness of breath, nausea, tingling dizziness, clammy hands, dilated pupils, perhaps fainting[healthnavigator.org.nz]
  • This lower level of carbon dioxide reduces blood flow to the brain, which may result in the following nervous system and emotional symptoms: Weakness Fainting Dizziness Confusion Agitation A feeling of being outside yourself Seeing images that aren't[emedicinehealth.com]
Polyneuropathy
  • We aimed to explore axonal excitability parameters in patients with diabetes mellitus (DM) and polyneuropathy (PNP) as well as those without PNP.[ncbi.nlm.nih.gov]
Panic Attacks
  • On the basis of the Diagnostic Symptom Questionnaire, a panic attack was defined as the following: 1) four or more symptoms of a panic attack from DSM-IV; 2) at least one of the cognitive symptoms of a panic attack from DSM-IV (e.g. fear of dying or of[scielo.br]
  • Next, how a panic attack causes the brain to behave in a certain way… Part 5: The Brain and Panic Attacks: 'Emotional Hijacking' »[panic-attacks.co.uk]
  • Usually this hyperventilation is anxiety related or a panic attack, but sometimes it can be caused by a serious underlying condition like pulmonary embolus. Acute shortness of breath in any patient should never be dismissed lightly.[ncbi.nlm.nih.gov]
  • HVS is frequently caused by anxiety disorders and panic attacks. Until now, medical literature has focussed primarily on daytime symptoms of behavioural hyperventilation. It is currently unknown how this condition may affect sleep.[ncbi.nlm.nih.gov]

Workup

  • Twenty-two of the 29 patients referred for ENS during the study period were eligible for inclusion and underwent a complete workup. HVS was diagnosed in 17 of these patients (77.3%).[ncbi.nlm.nih.gov]
Hypocapnia
  • Oxygen uptake during the 30-s WAnT was lower in the hypocapnia than the control trial (1.55 0.52 vs. 1.95 0.44 L min(-1)), while the postexercise peak blood lactate concentration was higher in the hypocapnia than control trial (10.4 1.9 vs. 9.6 1.9 mmol[ncbi.nlm.nih.gov]
  • Hypocapnia was developed through voluntary hyperventilation for 20 min prior to Ex1 and during each recovery period. End-tidal CO2 pressure was lower before each exercise in the hypocapnia than control trials.[ncbi.nlm.nih.gov]
  • Cerebral hypoperfusion and TLOC have been associated with hypocapnia related to HV.[ncbi.nlm.nih.gov]
  • PHV produces hypocapnia before the stimulus, modifies patients' TcPCO2 values throughout the ECT session and lengthens seizure duration. Voluntary hyperventilation is the most important part of the PHV procedure with respect to achieving hypocapnia.[ncbi.nlm.nih.gov]
  • In this case, we found capnography to be a very useful aid to monitor respiration in this patient and also to treat the hypocapnia.[ncbi.nlm.nih.gov]

Treatment

  • Topiramate is a recently released antiepileptic agent used in the treatment of patients with refractory seizure disorders.[ncbi.nlm.nih.gov]
  • Quetiapine is an atypical antipsychotic with favorable properties in the treatment of bipolar disorder, but it has recently been associated with respiratory dysfunction.[ncbi.nlm.nih.gov]
  • However, no information could be extracted from the paper regarding the size of the treatment effects. The results of this systematic review are unable to inform clinical practice, based on the inclusion of only one small, poorly reported RCT.[ncbi.nlm.nih.gov]
  • Supportive and disease-specific treatments, including oopherectomy, plasmapheresis and intravenous immunoglobulin, provided excellent recovery. These observations suggest that NMDA receptors may play a role in the pathophysiology of CNH.[ncbi.nlm.nih.gov]
  • A 69-year-old African-American woman admitted to a psychiatric hospital for treatment of major depression with psychotic features was treated and successfully discharged with quetiapine, along with metronidazole and miconazole to treat bacterial/monilial[ncbi.nlm.nih.gov]

Prognosis

  • Prognosis Prognosis is generally good but will depend on the underlying cause and comorbidity. [ 12 ] Management of associated disorders (such as agoraphobia) will alter the course of the hyperventilation.[patient.info]
  • Pneumothorax (Symptoms, Causes, Types, and Prognosis) A pneumothorax is free air in the chest outside the lung, that causes the lung to collapse (collapsed lung). There are two types...[medicinenet.com]
  • Hyperventilation Prognosis With appropriate training, a person may use stress -reduction techniques, breathing exercises, and certain medications to reduce the number and severity of the hyperventilation attacks.[emedicinehealth.com]

Etiology

  • Concurrent etiologies of peripheral hyperventilation were excluded, leaving central neurogenic hyperventilation as the remaining etiology.[ncbi.nlm.nih.gov]
  • Other possible etiologies of the central hyperventilation syndrome were excluded. The problem resolved within 24 hours after discontinuing topiramate.[ncbi.nlm.nih.gov]
  • W. , “The etiology of effort syndrome” , Amer. J. med. Sci. , 1938 , 196 , 840 . Stead , E. A. , and Warren , J. V. , “The role of hyperventilation in the production, diagnosis and treatment of certain anxiety symptoms” , Amer. J. med.[bjp.rcpsych.org]
  • Because of its bizarre manifestations and its basic etiology, it is seen by everyone regardless of the limitation of one's practice. Too many of us have been lulled into a sense of false security by medical school teachings.[aafp.org]
  • Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'.[icd10data.com]

Epidemiology

  • Epidemiology It is quite common but precise prevalence is unknown.[patient.info]
  • […] asthma status was seen to significantly influence the probability of HVS occurrence, with the ORs for HVS in adolescents with lifetime asthma, current episodic asthma, and current active asthma calculated as 11.2, 8.9, and 41.5, respectively. [ 4 ] Epidemiology[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • HRV analysis points towards an autonomic overactivation as a pathophysiological pathway subtending seizure triggered by hyperventilation in MTLE.[ncbi.nlm.nih.gov]
  • These observations suggest that NMDA receptors may play a role in the pathophysiology of CNH.[ncbi.nlm.nih.gov]
  • Central neurogenic hyperventilation is a rare condition with poorly understood pathophysiology. To describe a patient with central neurogenic hyperventilation caused by an infiltrative brainstem lymphoma.[ncbi.nlm.nih.gov]
  • These patients represent the first reported cases of HVN after stereotactic radiation and illustrate the pathophysiology of HVN, which may lead to a greater understanding of the effects of stereotactic radiotherapy.[ncbi.nlm.nih.gov]
  • No differences in EBT are seen between asthmatics and healthy controls, indicating that the increase in EBT is mainly physiological rather than pathophysiological.[ncbi.nlm.nih.gov]

Prevention

  • Awareness of the responsible factors will promote detection and prevention of the hazard.[ncbi.nlm.nih.gov]
  • Hypocapnia may prevent further slowing of V O2p kinetics in hypoxic exercise.[ncbi.nlm.nih.gov]
  • A mask was packaged and applied daytime to the face of the patient during episodes of hyperventilation to prevent, together with a psychiatric follow up, rapid falls of PaCO2 levels determining central apnoeas.[ncbi.nlm.nih.gov]
  • To help prevent problems, tell your healthcare provider and pharmacist about all the medicines, natural remedies, vitamins, and other supplements that you take.[summitmedicalgroup.com]
  • In the present study, preventing the fall in end-tidal P(CO₂) (NORMO) restored LBF kinetics, but not V(O₂p) kinetics, which remained 'slowed' relative to CON.[ncbi.nlm.nih.gov]

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Last updated: 2017-05-04 12:59