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Related Experiment Videos

Idiopathic bilateral diaphragmatic paralysis.

Josep Valls-Solé1, Margarita Solans

  • 1Unitat d'EMG, Servei de Neurologia, Hospital Clinic, Facultad de Medicina, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS),Universitat de Barcelona, Villarroel 170, Barcelona 08036, Spain. jvalls@clinic.ub.es

Muscle & Nerve
|April 5, 2002
PubMed
Summary

Idiopathic neuritis can affect the phrenic nerves, causing bilateral diaphragmatic paralysis. This case shows potential for recovery and reinnervation in phrenic nerves after neuritis.

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Area of Science:

  • Neurology
  • Pulmonology
  • Electromyography

Background:

  • Bilateral diaphragmatic paralysis presents with dyspnea and chest pain.
  • Diagnosis involves clinical breathing pattern assessment and pressure recordings.
  • Portable bi-level positive airway pressure apparatus (BiPAP) can aid management.

Observation:

  • Needle electromyography revealed significant fibrillation potentials in the diaphragm.
  • No response to phrenic nerve stimulation was observed initially.
  • The patient experienced subacute onset of paralysis with localized pain.

Findings:

  • Follow-up showed progressive respiratory function improvement over 9-12 months.
  • Reinnervation potentials appeared in the diaphragm.
  • Polyphasic, long-latency responses to phrenic nerve stimulation emerged.

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Implications:

  • Subacute onset, pain, and recovery suggest proximal phrenic nerve lesions.
  • The phrenic nerve may be a target in idiopathic neuritis.
  • This highlights the potential for idiopathic neuritis to affect the phrenic nerve.