Unilateral somatic symptoms due to hyperventilation.

Small CW. Clinical measurement of myocardial infarct size: modification of a method for the estimation of creatine phosphokinase release after acute myocardial infarction. Unilateral somatic symptoms due to hyperventilation Recurrent unilateral sensory or motor symptoms (or both) are a poorly recognised presentation of the hyperventilation syndrome. We have seen 12 such cases during the past two years and here describe two cases in detail and 10 in tabular form. Case reports Case 1-A 19 year old school leaver unable to find work gave a six month history of recurrent episodes of numbness and weakness of her left hand and arm. Each episode lasted a few minutes and she simultaneously felt dizzy, light headed, had difficulty taking a deep breath, and felt tightness in the chest. Investigation elsewhere for suspected epilepsy proved negative. Physical examination showed no abnormality, though she was overtly anxious: voluntary hyperventilation reproduced all her symptoms. She was reassured and the mechanism explained. A physiotherapist taught her breathing exercises, which she continued for a few weeks. When reviewed two years later she was well without recurrence of symptoms. Case 6-A 30 year old male banker had had intermittent paraesthesiae affecting the left face, arm, and leg for four months. Episodes lasted several minutes and could recur up to three times a week. He was referred with suspected cerebrovascular disease. Physical examination showed no abnormality but he was anxious about his job. Voluntary hyperventilation reproduced his attacks but no other symptoms such as dizziness. After explanation he was taught breathing exercises by a physiotherapist and remained free of symptoms when reviewed two years later. The table summarises details of 12 cases (including the above). Individual episodes lasted from two to 20 minutes and had been present for between one month and two years. Left limbs were more commonly affected than the right. Only one patient complained of breathlessness even on direct questioning, and dizziness was not always present. Each patient had a background of anxiety. Physical examination showed no abnormality, but in each case voluntary hyperventilation evoked the presenting symptoms within a half to Clinical details of 12 patients with unilateral somatic symptoms due to hyperventilation Previous Period of Case No Age Sex Unilateral somatic symptoms and side affected Other symptoms diagnosis follow up 1 19 F Numbness and weakness of arm. Left side Dizziness. Chest felt tight Epilepsy->2 years 2 23 F Numbness of hand, tongue, and lips. …