Diaphragmatic paralysis (patient information)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahda Alihashemi M.D. [2]

Unilateral diaphragmatic paralysis is usually asymptomatic. Respiratory distress is seen in bilateral diaphragmatic paralysis. Causes of diaphragmatic paralysis include unknown in many cases, Phrenic nerve injury in cardiac surgery and some viral infections. Patients after cardiac surgery and viral infection are at higher risk. Chest radiography, fluoroscopic sniff test , measurement of transdiaphragmatic pressure (Pdi) and ultrasound are diagnostic studies for diaphragmatic paralysis. Treatment options include ventilatory support and diaphragmatic pacing. Prognosis is excellent in unilateral diaphragmatic paralysis, but bilateral diaphragmatic paralysis is a medical emergency.

Unilateral diaphragmatic paralysis:

• Usually without any symptoms
• Shortness of breath during exercise
• shortness of breath with lying flat position
• Low level of energy

Bilateral diaphragmatic paralysis:

• Respiratory distress

• Unknown in many causes
• Phrenic nerve injury in cardiac surgery 
• Some viral infections
• Large tumors in cervical spinal cord
• Amyotrophic lateral sclerosis
• Guillain-Barré syndrome
• Thyroid Disease
• Amyotrophic lateral sclerosis
• Polymyositis
• Neck injury

• Patients after open heart surgery
• Patients after viral infection
• Patients with neurologic disease

• Chest radiography
• Fluoroscopic sniff test
• Measurement of transdiaphragmatic pressure (Pdi) 
• Ultrasound

• In acute respiratory distress

• Ventilatory support
• Diaphragmatic pacing: stimilation of the diaphragm by putting electrodes in neck or thorax.

Medical care for (disease name) can be found here.

• Proper treatment of underlying diseases and infections.

• Prognosis is generally excellent in unilateral diaphragmatic paralysis, but bilateral diaphragmatic paralysis is a medical emergency.

• Severe pulmonary dysfunction 

http://www.nlm.nih.gov/medlineplus/ency/article/000434.htm

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