Hypoxia and hypercapnia accompany respiratory insufficiency and are the primary causes for neurologic manifestations seen in this disorder. Respiratory acidosis is associated with hypercapnia if respiratory failure is acute.
Acute respiratory insufficiency can occur in people with previously normal lungs. Recent abdominal surgery may cause atelectasis or spontaneous pneumothorax and pulmonary infections.
Chronic respiratory insufficiency can have many causes:138
Clinical manifestations of respiratory insufficiency include:
Increased intracranial pressure143,144 may produce
The EEG may show diffuse slowing and no variation from other metabolic encephalopathies.
Two factors make seizures a possible complication of respiratory insufficiency:
Treatment of respiratory insufficiency requires the improvement of gas exchange as well as treatment of the underlying cause for the insufficiency (e.g., by treatment of an infection or insertion of a chest tube in the case of trauma).
Treatment of the underlying causes also eliminates seizures in such cases, so there is usually no need for chronic administration of antiepileptic drugs.
Acute seizure treatment may include carefully monitored and administered benzodiazepines or phenytoin.
Adapted from: Sepkuty JP and Kaplan PW. Hematologic and pulmonary disorders. In: Ettinger AB and Devinsky O, eds. Managing epilepsy and co-existing disorders. Boston: Butterworth-Heinemann; 2002;209–228. With permission from Elsevier (www.elsevier.com).
Reviewed and revised April 2004 by Steven C. Schachter, MD, epilepsy.com Editorial Board.
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