[Diaphragmatic paralysis and paresis : review]

Area of Science:

• Pulmonology
• Neurology
• Thoracic Surgery

Background:

• Diaphragmatic paresis/paralysis presents with varied severity, from asymptomatic cases to respiratory failure.
• It can be unilateral or bilateral, with distinct causes and prognoses.

Purpose of the Study:

• To summarize the clinical manifestations, diagnostic findings, and management strategies for diaphragmatic dysfunction.
• To differentiate between unilateral and bilateral cases and their typical outcomes.

Main Methods:

• Review of clinical presentations and diagnostic criteria for diaphragmatic paresis/paralysis.
• Analysis of treatment options, including conservative management and surgical interventions.

Main Results:

• Respiratory functional tests show reduced respiratory pressures and a restrictive syndrome.
• Vital capacity decreases in the supine position compared to sitting.
• Unilateral paresis is often post-surgical and self-limiting; bilateral dysfunction, common in neuromuscular diseases, is typically permanent.

Conclusions:

• Effective management requires addressing underlying causes and comorbidities.
• Interventions may include diaphragmatic plication, ventilatory support, or phrenic nerve pacing for severe or permanent cases.