Obstructive sleep apnea hypopnea syndrome and alveolar hypoventilation syndrome in motor neuron disease:a case report and literature review

【作者】 周莉； 欧阳若芸； 陈平； 罗红； 刘贵钱；

【机构】 中南大学湘雅二医院呼吸内科；

【摘要】 Objective:To analyze the clinical characteristics of a patient with motor neuron disease which caused obstructive sleep apnea hypopnea syndrome(OSAHS)and alveolar hypoventilation syndrome,and raise the understanding and diagnosis rate of this disease.Method:Retrospectively analyze the diagnosis and treatment process of a 52 year-old male patient who was accepted by The Second Xiangya Hospital,Central South University because of dyspnea,shortness of breath and malaise for 4 months,and eventually was diagnosed as motor neuron disease associated with OSAHS and alveolar hypoventilation syndrome,which is an intractable and significant case.Besides,we searched HowNet,WanFang and PubMed databases to review related literature.Result:The major clinical manifestation of motor neuron disease is impaired upper and lower motor neuron which appeared as proximal muscle weakness,muscle tremor,amyotrophy,bulbar symptoms and pyramidal sign.And it is a chronic,progressive disease with worse prognosis,low survival and more intractable to diagnose most of time in which electroneuromyography is an vital examination for diagnosis.What’s more,sleep disordered breathing is common in patients with motor neuron disease which is featured as decreased rapid eye movement sleep,increased awaking time and frequency,apnea and hypopnea.The main mechanism of sleep disordered breathing in motor neuron disease is disturbed central nervous system and paralysis of diaphragm and respiratory muscle.Moreover,the patient is susceptible to suffer with restrictive ventilatory dysfunction and alveolar hypoventilation and subsequent partial pressure of carbon dioxide and hypoxemia.Therefore,respiratory failure is the most frequent cause of death in patients of motor neuron disease.non-invasive positive pressure ventilation is suggested to apply in such patients who forced vital capability is less than 75 percent of predicted value.Conclusion:Sleep disordered breathing is common in patients with motor neuron disease.Hence,polysomnography is suggested as a routine examination when physicians receive such patients in order to recognize potential complications and give timely therapy.What’s more,treatment with non-invasive positive pressure ventilation reasonably is important for patients to improve life quality,survival rate and prognosis.更多还原

【Abstract】 Objective:To analyze the clinical characteristics of a patient with motor neuron disease which caused obstructive sleep apnea hypopnea syndrome(OSAHS) and alveolar hypoventilation syndrome,and raise the understanding and diagnosis rate of this disease.Method:Retrospectively analyze the diagnosis and treatment process of a 52 year-old male patient who was accepted by The Second Xiangya Hospital,Central South University because of dyspnea,shortness of breath and malaise for 4 months,and eventually was diagnosed as motor neuron disease associated with OSAHS and alveolar hypoventilation syndrome,which is an intractable and significant case.Besides,we searched HowNet,WanFang and PubMed databases to review related literature.Result:The major clinical manifestation of motor neuron disease is impaired upper and lower motor neuron which appeared as proximal muscle weakness,muscle tremor,amyotrophy,bulbar symptoms and pyramidal sign.And it is a chronic,progressive disease with worse prognosis,low survival and more intractable to diagnose most of time in which electroneuromyography is an vital examination for diagnosis.What’s more,sleep disordered breathing is common in patients with motor neuron disease which is featured as decreased rapid eye movement sleep,increased awaking time and frequency,apnea and hypopnea.The main mechanism of sleep disordered breathing in motor neuron disease is disturbed central nervous system and paralysis of diaphragm and respiratory muscle.Moreover,the patient is susceptible to suffer with restrictive ventilatory dysfunction and alveolar hypoventilation and subsequent partial pressure of carbon dioxide and hypoxemia.Therefore,respiratory failure is the most frequent cause of death in patients of motor neuron disease,non-invasive positive pressure ventilation is suggested to apply in such patients who forced vital capability is less than 75 percent of predicted value.Conclusion:Sleep disordered breathing is common in patients with motor neuron disease.Hence,polysomnography is suggested as a routine examination when physicians receive such patients in order to recognize potential complications and give timely therapy.What’s more,treatment with non-invasive positive pressure ventilation reasonably is important for patients to improve life quality,survival rate and prognosis.更多还原