失声を伴つた心因性呼吸困難（過換気症候群）の1症例

FUNCTIONAL DYSPNEA WITH APHONIA, A CASE REPORT

　心因性呼吸困難は精神的動機により呼吸困難を起こした状態であり，近年煩雑化した社会機構の中で，この種の心因性疾患に遭遇する機会は益々増加してきている。しかし耳鼻科領域においては，心因性失声症，心因性難聴などに比べると，心因性呼吸困難については報告もほとんど見られず，一般の認識も高くないものと思われる。われわれは最近，失声症を伴つた心因性呼吸困難の症例で過換気症候群と思われる症状を呈した1例を経験したので少しく考察を加えて，ここに報告する次第である。

　A woman, aged 43, was admitted to the hospital as an emergency case complaining of acute dyspnea and aphonia. The patient at admission showed symptoms of respiratory over-aeration but a few hours thereafter these symptoms abated with a restfulness.

　Examination showed a slight localized paralysis of the vocal cords but otherwise normal in health. However, the history revealed the patient to be under a severe nervous strain in being over-worked in physical occupation and an extreme phobia of laryngeal cancer. The diagnosis of functional dyspnea and aphonia under an acute mental strain was made. The treatment was effected by the aid of psychotherapist. The patient made a complete recovery in 23 days of hospitalization with the exception of the presence of high pitch in her conversation voice.