Convulsions de reventilation

In this study, the case was reported of a 60-year-old male with a chronic respiratory disorder following a poliomyelitic infection. He was treated by a SAMU team (Glasgow score=4) for a comatose state, and no sign of localization of disease or meningitis was found. Given the preliminary diagnostic findings, mechanical ventilation was instigated; and several minutes later generalized seizures were observed which did not respond to 10 mg diazepam, but which continued when the subject was admitted to the emergency ward, The following day, the patient appeared to have regained normal function and consciousness. It was concluded that these seizures were due to a rapid acidemia-alcalemia shift in a person with a preexisting chronic respiratory disorder.

Nous rapportons le cas d’un malade insuffisant respiratoire chronique qui a convulsé à deux reprises lors de la correction rapide d’une hypercapnie à la mise en route d’une ventilation artificielle. Le facteur déclenchant de ces convulsions semble être une alcalémie dont les conséquences sont discutées. Cette complication potentielle incite à ne pas corriger trop rapidement une hypercapnie au cours des premières heures de ventilation artificielle chez l’insuffisant respiratoire décompensé.