Related Experiment Video
Updated: May 21, 2026

Diaphragmatic Ultrasound in Adults: Image Acquisition and Interpretation
Published on: January 31, 2025
Paradoxical abdominal wall movement in bilateral diaphragmatic paralysis
Rebekah Ahmed1, Stephen McNamara, Simon Gandevia
1Department of Neurology, Royal Prince Alfred Hospital, Sydney, Australia. rebekahahmed@gmail.com
Abstract:
A 56-year-old man gave a 6-month history of progressive dyspnoea and orthopnoea. During breathing, his abdominal muscles showed paradoxical movement and he rapidly and reproducibly developed difficulty breathing when lying supine. The most likely explanation was severe weakness or paralysis of both hemidiaphragms. This was confirmed with electrophysiology and ultrasonography. Extensive investigation identified no underlying cause, suggesting this is a case of bilateral isolated phrenic neuropathy. We present a video showing how easily bilateral diaphragmatic palsy can be detected clinically through identifying paradoxical abdominal wall movement.
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