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Hemidiaphragmatic Paralysis Post Stroke Leading to Hypercapneic Respiratory Failure
Antony J Arumairaj1, Sanket Agarwal2, Rachana Borkar2
1Internal Medicine, Metropolitan Hospital Centre, New York, USA.
Cureus
|March 17, 2021
Summary
Unilateral diaphragmatic paralysis, a rare stroke complication, can cause breathing difficulties and pneumonia. Prompt non-invasive ventilation and antibiotics led to significant recovery in a recent case.
Area of Science:
- Neurology
- Pulmonology
- Critical Care Medicine
Background:
- Unilateral diaphragmatic paralysis is an uncommon post-stroke complication.
- Stroke-induced diaphragmatic dysfunction can lead to respiratory compromise.
Observation:
- A 51-year-old man developed right-sided hemidiaphragmatic paralysis following a stroke.
- Symptoms included shortness of breath and orthopnea, with chest X-ray showing an elevated right hemidiaphragm.
Findings:
- Paralysis caused right lung base atelectasis and impaired ventilation.
- This led to right basal pneumonia and hypercapneic respiratory failure.
Implications:
- This case highlights the importance of recognizing diaphragmatic paralysis after stroke.
- Non-invasive ventilation and medical management are effective treatments.
- Early intervention can prevent severe respiratory complications.
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