Bilateral Phrenic Nerve Palsy Associated With Neuralgic Amyotrophy

Area of Science:

• Neurology
• Immunology

Background:

• Neuralgic amyotrophy (NA) is an inflammatory neuropathy typically affecting the upper extremities.
• Phrenic nerve involvement is an uncommon manifestation of NA.

Observation:

• A male patient presented with neck pain, orthopnea, and supine hypoxemia.
• Physical examination revealed right shoulder muscle atrophy and an inability to slurp.
• Diagnostic tests confirmed bilateral phrenic nerve palsy.

Findings:

• The patient was diagnosed with bilateral phrenic nerve palsy secondary to neuralgic amyotrophy.
• This case demonstrates a rare presentation of NA involving the diaphragm.

Implications:

• NA can lead to significant respiratory compromise through phrenic nerve involvement.
• Recognizing NA as a cause of phrenic palsy is crucial for timely diagnosis and management.
• This case underscores the importance of considering NA in patients with unexplained respiratory symptoms and diaphragmatic dysfunction.