RT Journal Article
SR Electronic
T1 Central hypoventilation as the presenting symptom in Hu associated paraneoplastic encephalomyelitis
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 1143
OP 1145
DO 10.1136/jnnp.2007.117994
VO 78
IS 10
A1 Manuel J Gómez-Choco
A1 Juan J Zarranz
A1 Albert Saiz
A1 María I Forcadas
A1 Francesc Graus
YR 2007
UL http://jnnp.bmj.com/content/78/10/1143.abstract
AB Central hypoventilation is usually caused by ischaemic or neoplastic lesions of the medulla and upper cervical spinal cord. An autoimmune disorder is not usually considered in the differential diagnosis of this syndrome. We retrospectively identified 14 patients from our database of 202 patients with Hu antibodies who presented with brainstem symptoms. Three were admitted to hospital because of central hypoventilation. All underwent intubation and mechanical ventilation. They could breathe properly while they were awake but suffered deep apnoeas during sleep. Two died, but one is still alive requiring ventilatory assistance during sleep. Autopsy was performed in one of the patients which showed severe inflammatory infiltrates and neuronal loss in the medulla. All patients had normal brain imaging studies and the cause of central hypoventilation was an unsolved problem until Hu antibodies were determined.