Hostname: page-component-7c8c6479df-xxrs7 Total loading time: 0 Render date: 2024-03-28T09:21:31.671Z Has data issue: false hasContentIssue false

Psychophysiological Investigations of Patients with Unilateral Symptoms in the Hyperventilation Syndrome

Published online by Cambridge University Press:  02 January 2018

G. O'Sullivan*
Affiliation:
Department of Experimental Psychopathology, Institute of Psychiatry, London SE5
I. Harvey
Affiliation:
The National Hospital for Nervous Diseases, Queen Square, London WC1
C. Bass
Affiliation:
Department of Psychological Medicine, King's College Hospital, Denmark Hill, London SE5
M. Sheehy
Affiliation:
King's College Hospital, Denmark Hill, London SE5
B. Toone
Affiliation:
Department of Psychological Medicine, King's College Hospital, Denmark Hill, London SE5
S. Turner
Affiliation:
Department of Psychiatry, Middlesex Hospital, Mortimer Street, London W1
*
Orchard House, Joyce Green Hospital, Dartford, Kent DA1 5PL

Abstract

Anxiety states sometimes lead to hyperventilation (HV) which may, in turn, give rise to a variety of physical symptoms. One way in which HV may present is with unilateral somatosensory symptoms, often left-sided. We report nine such cases. The mechanism of lateralisation was examined using EEG and bilateral somatosensory evoked potentials which were carried out before and after HV. No difference in conduction velocity was found between affected and unaffected arms, but non-specific abnormalities were frequently noted in the EEGs. The results support the role of a central rather than a peripheral mechanism in the production of unilateral symptoms in HV.

Type
Papers
Copyright
Copyright © The Royal College of Psychiatrists, 1992 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Ames, F. (1955) The hyperventilation syndrome. Journal of Mental Science, 104, 466525.CrossRefGoogle Scholar
Annett, M. (1970) A clarification of hand preference by association analysis. British Journal of Psychology, 61, 303321.Google Scholar
Bass, G. & Gardner, W. (1985) Emotional influences on breathing and breathlessness. Journal of Psychosomatic Research, 29, 599609.CrossRefGoogle ScholarPubMed
Blau, J. N., Wiles, C. M. & Solomon, F. S. (1983) Unilateral somatic symptoms due to hyperventilation. British Medical Journal, 286, 1108.CrossRefGoogle ScholarPubMed
Compernolle, T., Hoogduin, K. & Joele, L. (1979) Diagnosis and treatment of the hyperventilation syndrome. Psychosomatics, 19, 612625.Google Scholar
Coyle, P. K. & Sterman, A. B. (1986) Focal neurologic symptoms in panic attacks. American Journal of Psychiatry, 143, 648649.Google Scholar
Dean, C., Surthees, P. G. & Sarshidharan, S. P. (1983) Comparison of research diagnostic systems in an Edinburgh community sample. British Journal of Psychiatry, 142, 247256.Google Scholar
Dolle, W. (1964) Hyperventilation and hyperventilation syndrome. Medische Klinnick, 59, 645699.Google Scholar
Ferenczi, S. (1926) Further Contributions to the Therapy and Techniques of Psychoanalysis. London: Hogarth Press.Google Scholar
Galaburda, A. M., LeMay, M., Kemper, T. L., et al (1978) Right-left asymmetries in the brain. Science, 199, 852856.CrossRefGoogle ScholarPubMed
Galin, D. (1974) Implications for psychiatry of left and right cerebral specialisation. Archives of General Psychiatry, 31, 573583.CrossRefGoogle Scholar
Galin, D., Dimond, R. & Braff, D. (1977) Lateralization of conversion symptoms more frequent on the left. American Journal of Psychiatry, 134, 578580.Google ScholarPubMed
Gardner, W. N. & Bass, C. (1984) A respiratory and psychiatric study of patients with symptomatic hyperventilation. Bulletin European de Physiopathologie Respiratoire, 20, 92.Google Scholar
Garssen, B. (1980) Role of stress in the development of the hyperventilation syndrome. Psychotherapy and Psychosomatics, 33, 214225.Google Scholar
Garssen, B., Van Weenendael, W. & Bloemink, R. (1983) Agoraphobia and the hyperventilation syndrome. Behaviour Research and Therapy, 21, 643649.Google Scholar
Garssen, B. & Rijken, H. (1986) Clinical aspects and treatment of the hyperventilation syndrome. Behavioural Psychotherapy, 14, 4668.Google Scholar
Grossman, P., Swart, J. C. & Defares, P. B. (1985) A controlled study of breathing therapy for treatment of hyperventilation syndrome. Journal of Psychosomatic Research, 29, 4958.CrossRefGoogle ScholarPubMed
Gruzelier, J. H. (1989) Lateralization and central mechanisms in clinical psychophysiology. In Handbook of Clinical Psychophysiology (ed. Turpin, G.). Chichester: Wiley.Google Scholar
Halliday, J. (1937) Psychological factors in rheumatism. British Medical Journal, 1, 264269.CrossRefGoogle ScholarPubMed
Kenyon, F. E. (1964) Hypochondriasis: a clinical study. British Journal of Psychiatry, 110, 478488.Google Scholar
Kugelberg, E. (1948) Activation of human nerves by hyperventilation and hypocalcaemia. Archives of Neurology and Psychiatry, 60, 153164.Google Scholar
Margarian, G. L. (1982) Hyperventilation syndrome: infrequently recognized common expression of anxiety and stress. Medicine, 61, 219236.CrossRefGoogle Scholar
Perkins, G. D. & Joseph, R. (1986) Neurological manifestations of the hyperventilation syndrome. Journal of the Royal Society of Medicine, 79, 448450.CrossRefGoogle Scholar
Robins, L. M., Helzer, J. E., Orvaschel, H., et al (1985) The Diagnostic Interview Schedule. In Epidemiologic Field Methods in Psychiatry. The NIMH Epidemiologic Catchment Area Program (eds Eaton, W. W. & Kessler, L. G.). New York: Academic Press.Google Scholar
Speckman, E. J. & Caspers, H. (1973) Neurophysiologische Grundlagen der Provokationsmethoden in due Elektranzeph alographie. Zeitschrift fur Elektroenzen-phalographies und Elektromyographic, 4, 157167.Google Scholar
Spehlmann, R. (1981) EEG Primer. Amsterdam: Elsevier.Google Scholar
Tavel, M. E. (1964) Hyperventilation syndrome with unilateral somatic symptoms. Journal of the American Medical Association, 187, 301303.Google Scholar
Tucker, D. M., Roth, R. S., Arneson, B. A., et al (1977) Right hemisphere activation during stress. Neuropsychologica, 15, 697700.Google Scholar
Weimann, G. (1968) Das Hyperventilationsyndrom. Munich: Urban & Scharzerberg.Google Scholar
Woolman, H., Smith, T. C., Stephen, G. W., et al (1968) Effects of extremes of respiratory and metabolic alkalosis on cerebral blood flow in man. Journal of Applied Physiology, 24, 6065.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.