Brachial neuritis involving the bilateral phrenic nerves

Area of Science:

• Neurology
• Pulmonology
• Immunology

Background:

• Brachial neuritis typically affects the nerves of the shoulder and arm.
• Bilateral hemidiaphragmatic paralysis is an extremely rare complication.
• Previous literature documents only two such cases.

Observation:

• A patient presented with progressive bilateral shoulder pain and subsequent respiratory distress.
• Clinical examination revealed bilateral elevated hemidiaphragms, reduced vital capacity, and proximal muscle weakness.
• Diagnostic tests indicated bilateral phrenic neuropathy.

Findings:

• The patient's symptoms were attributed to an unusual manifestation of brachial neuritis involving the phrenic nerves.
• Electromyography showed reduced muscle recruitment in the shoulder girdle.
• Nerve conduction studies confirmed bilateral phrenic neuropathy.

Implications:

• This case expands the known clinical spectrum of brachial neuritis.
• It underscores the importance of considering brachial neuritis in the differential diagnosis of acute shoulder pain with respiratory symptoms.
• Early recognition and diagnosis are crucial for appropriate patient management.