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February 1965

Motor System Disease: Review and Discussion of a Case Presenting With Alveolar Hypoventilation

Author Affiliations


From the Department of Medicine, University of Maryland School of Medicine and University Hospital.

Arch Intern Med. 1965;115(2):192-197. doi:10.1001/archinte.1965.03860140072016

ALTHOUGH inadequate alveolar ventilation occurs in numerous systemic diseases, only rarely has it been described occurring as the presenting system complex resulting from a motor system disease. Recently we studied a patient who presented with fatigue, somnolence, and periodic respiratory signs ascribed to alveolar hypoventilation and its consequent blood gas abnormalities. In the absence of pathologic examination of the nervous system of our patient we feel clinical evaluation of his motor system disease would best place it in the category of amyotrophic lateral sclerosis (ALS).

Report of Case  The patient (U.H. 19-64-73), a 49-year-old Caucasian businessman was hospitalized for medical survey because of increasing tiredness. For approximately five years there was gradual progression of fatigability and lethargy with physical activity provoking exhaustion without dyspnea. Drowsiness was frequent although he slept poorly at night. His wife noted an irregular respiratory pattern, notably nocturnal, which varied cyclically from near apnea to tachypnea.