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Abstract

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Article in Japanese

Case Report

Recurrent pulmonary edema associated with obstructive sleep apnea syndrome

Tomoko Yanaihara1)  Masanori Yokoba1)  Masaru Kubota1)  Yasuto Nishii1)  Matakichi Miyamoto2)  Tadashi Abe1)  Noriyuki Masuda1)  Masato Katagiri1) 

1)Respiratory Medicine, Kitasato University 2)Keiyu Hospital

ABSTRACT

A 70-year-old non-obese man with no history of cardiopulmonary disease presented 4 times to the emergency room because of sudden onset of seizure during sleep. Each time he recovered within a few hours without any medication. Nocturnal polysomnographic recording revealed severe obstructive sleep apnea syndrome (OSAS, AHI 52.4/Hr). Nasal continuous positive airway pressure (n-CPAP) therapy was performed with 10 cmH2O of pressure. His symptoms of severe daytime sleepiness and seizure were diminished. CPAP was decreased from 10 cmH2O to 6 cmH2O later, because the patient complained with its high pressure. He then felt daytime sleepiness and suffered seizures during sleep again, and was re-admitted to our hospital. Chest roentgenogram taken at this admission showed remarkable pulmonary edema. We found that the pulmonary edema was recognized every time on his chest roentgenogram taken when he complained seizure. In addition, subsequesnt roentgenograms also showed that the pulmonary edema was diminished soon. On the other hand, his AHI was high (24.7/hr) even when he was under 6 cmH2O of n-CPAP. We concluded that incompletely treated OSAS might lead not only to pulmonary edema, but also to seizures in this patient.

KEYWORDS

Obstructive sleep apnea syndrome  Pulmonary edema  Seizure 

Received 平成18年1月11日

JJRS, 44(11): 812-816, 2006

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