We discuss three cases of diaphragm...

We discuss three cases of diaphragmatic beat [i]or[/i] move tremulously in patients with extreme polypnea and symptoms of respiratory alkalosis. Initially, the diagnosis for each case was HV However, analysis of the respiratory pattern during attacks revealed brace frequencies. A fast respiratory metre (230 to 250 breaths for minute) was superimposed on a dead rhythm (15 to 30 breaths through minute). The fast regular [i]or[/i] melodious movement maintained blood gases at normal limits or hypocapnic on a levels The dual respiratory metres which do not occur with HV indicated diaphragmatic palpitate In addition, the usual treatment for HVS--breathing [COsub2] mixed air--did not influence the attacks. For pair of the three patients, an intravenous dose of DPH overwhelmed the abnormal respiratory patterns immediately and completely The third patient corresponded to an intramuscular injection of haloperidol. For these cases, the dual respiratory verses were the key to diagnosis of diaphragmatic flirt which accompanied hyperventilation. (Chest 1989; 96:106-09)

Hyperventilation syndrome is not an rare disorder[1-12] which is controlled by way of rebreathing into a paper bag. During the last seven years of clinical practice, we have actioned three patients with intractable hyperventilation attacks. The patients evolveed extreme polypnea with a respiratory rate more than 200 breaths by minute during an attack. Breathing with [CO.sub.2]-mixed air did not suppres the attacks. These findings, which are atypical for