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[An unrecognized cause of dyspnoea]
1Zuyderland Medisch Centrum Sittard-Geleen, Geleen.
Nederlands Tijdschrift Voor Geneeskunde
|June 30, 2017
Summary
Bilateral phrenic nerve neuropathy, a rare neuralgic amyotrophy variant, causes diaphragmatic paralysis and breathing difficulty. Nocturnal nasal ventilation support improved patient quality of life.
Area of Science:
- Neurology
- Pulmonology
Background:
- Neuralgic amyotrophy (NA) is a condition causing neck/shoulder pain and brachial plexus neuropathy.
- A rare variant involves phrenic nerves, leading to diaphragmatic paralysis and orthopnoea.
Observation:
- A 67-year-old woman presented with acute orthopnoea.
- Imaging and EMG confirmed bilateral diaphragmatic paralysis and phrenic nerve neuropathy.
- The diagnosis was bilateral NA.
Findings:
- Isolated phrenic nerve neuropathy is a rare NA variant.
- Diaphragmatic paralysis causes severe orthopnoea.
- Recovery from phrenic nerve neuropathy is often slow and incomplete.
Implications:
- Non-invasive ventilation support is crucial for managing orthopnoea in NA.
- Supportive treatment improves quality of life for patients with diaphragmatic paralysis.
- Understanding this rare variant aids in timely diagnosis and management.
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