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Bilateral Phrenic Nerve Palsy in a Diabetic Causing Respiratory Failure
Robert Da Costa1, Pezad Doctor1, Kaustubh Mahajan1
1Department of Critical Care, Holy Family Hospital, Mumbai, Maharashtra, India.
Summary
Diabetic neuropathy can rarely affect the phrenic nerves, causing diaphragmatic palsy and respiratory failure. This case highlights the importance of considering diabetic phrenic neuropathy in patients with unexplained breathing difficulties.
Area of Science:
- Neurology
- Diabetology
- Pulmonology
Background:
- Neuropathy is a significant cause of morbidity in patients with diabetes mellitus (DM).
- Diabetic neuropathy encompasses a range of nerve disorders that can affect various nerve types.
Observation:
- A 64-year-old male with type 2 diabetes mellitus for over 6 years presented with orthopnea and respiratory failure.
- The patient's symptoms were attributed to bilateral phrenic neuropathy, leading to diaphragmatic palsy.
Findings:
- Clinical examination, ultrasound, and nerve conduction studies confirmed bilateral phrenic nerve involvement.
- This case demonstrates diaphragmatic dysfunction as a rare complication of diabetes.
Implications:
- Diabetic phrenic neuropathy should be considered in patients presenting with unexplained breathlessness, orthopnea, and respiratory failure.
- Early diagnosis and management of diabetic neuropathy can prevent severe complications like diaphragmatic dysfunction.
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