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Related Experiment Video

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Diaphragmatic Ultrasound in Adults: Image Acquisition and Interpretation
05:51

Diaphragmatic Ultrasound in Adults: Image Acquisition and Interpretation

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Diaphragmatic flutter.

Dean Walton1, Michael Bonello1, Malcolm Steiger1

  • 1Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK.

Practical Neurology
|February 9, 2018
PubMed
Summary
This summary is machine-generated.

A stroke survivor experienced involuntary abdominal movements due to diaphragmatic flutter, a rare condition. Treatment options are being explored, including phrenic nerve crush, due to persistent symptoms.

Keywords:
diaphragmatic flutterdiaphragmatic myoclonusmovement disorders

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Area of Science:

  • Neurology
  • Gastroenterology
  • Respirology

Background:

  • Diaphragmatic flutter is a rare disorder characterized by involuntary, high-frequency contractions of the diaphragm.
  • It can manifest as abnormal abdominal wall movements, dyspnea, and respiratory distress.
  • The condition requires a high index of suspicion for accurate diagnosis.

Observation:

  • A 78-year-old woman presented with hyperkinetic, predominantly right-sided abdominal wall movements following a right hemispheric stroke.
  • Brain MRI revealed a recent infarct in the right occipitotemporal lobe and right cerebellum.
  • Diaphragmatic fluoroscopy confirmed high-frequency flutter causing the abdominal movements.

Findings:

  • The patient's symptoms were diagnosed as van Leeuwenhoek's disease, a historical account of diaphragmatic flutter.
  • Despite medical management, the patient remained highly symptomatic.
  • Surgical intervention, specifically phrenic nerve crush, is being considered.

Implications:

  • This case highlights the importance of considering diaphragmatic flutter in patients with unexplained abdominal movements post-stroke.
  • Early diagnosis and appropriate management are crucial for improving patient outcomes.
  • Phrenic nerve crush presents a potential therapeutic option for refractory cases.