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—We thank Dr Plum for his interesting comments. The main point in our article is that primary cerebral lymphoma is the most common tumor that causes central neurogenic hyperventilation.1 We agree with Plum that its pathogenesis is still unknown.Regarding the possibility of brain-stem involvement in our case, we agree with Plum that it cannot be completely ruled out, since no necropsy was performed. However, the clinical manifestations correlate with the computed tomographic findings, and both support evidence for involvement of the hemispheres only. In an additional patient, no brain-stem involvement was found on computed tomographic scanning.2 Moreover, at the necropsy described by Bateman et al, "multiple sections showed no lesion of any kind in the brain stem below the superior colliculus."3The alkaline pH of the cerebrospinal fluid was found in our patient and in an additional one.3 Only one case of a
Pauzner R, Mouallem M, Sadeh M, Farfel Z. Cerebral Lymphoma and Central Hyperventilation-Reply. Arch Neurol. 1990;47(1):10–11. doi:10.1001/archneur.1990.00530010016002
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