We present a case series of four patients (all male, mean age 53) presenting with dyspnoea preceded by severe self-limiting upper limb and shoulder pain, with an elevated hemi-diaphragm on clinical examination and chest X-ray. [ncbi.nlm.nih.gov]

• Falling

  Guest over a year ago I had a fall down an elevator shaft head first several years ago and fractured my C4 spine. About a year later I was diagnosed with an elevated right Diaphragm. [steadyhealth.com]

  It therefore falls to the individual anesthesiologist to assess the likely impact of phrenic nerve palsy in any given patient undergoing shoulder surgery and to select the appropriate regional anesthetic technique accordingly. [anesthesiology.pubs.asahq.org]

• Chest Wall Pain

  wall pain Cough The symptoms can mimic the ones from cardiac dyspnea In case of bilateral phrenic nerve palsy, the patient can also present the following symptoms: Anxiety Insomnia Headaches (predominantly in the morning) Causes These are the causes [mddk.com]

• Hoarseness

  Recurrent laryngeal nerve is occasionally blocked as well, and this can lead to hoarseness and complete airway obstruction in patients with an existing vocal cord palsy (thus ask about hoarseness or previous neck surgery). [openanesthesia.org]

• Hiccup

  Other symptoms include: Problems with the hiccups. The hiccup reflex can be triggered by phrenic nerve irritation, making the diaphragm contract abnormally, resulting in a small intake of air. [averybiomedical.com]

  Irritation of the phrenic nerve (or the tissues supplied by it) leads to the hiccup reflex. A hiccup is a spasmodic contraction of the diaphragm, which pulls air against the closed folds of the larynx. [en.wikipedia.org]

  Phrenic nerve palsy Symptoms These are the most common symptoms of the phrenic nerve palsy: Dyspnea (shortness of breath) Orthopnea (dyspnea that is relieved by assuming the orthostatic position) Hiccups (also caused by the irritation of the respective [mddk.com]

  Also, you can have problems with the hiccups and the hiccups can be triggered by phrenic nerve irritation. This can result in a small intake of the air. [steadyhealth.com]

• Right Shoulder Pain

  […] nerve irritation is mainly located in the shoulder, it is conceivable for a patient to report right shoulder pain while the needle tip comes in contact with the phrenic nerve. [anesthesiology.pubs.asahq.org]

• Withdrawn

  In both ablation groups, the coronary sinus catheter was withdrawn from its original position and placed in the superior vein cava. [medsci.org]

• Excitement

  After doing so, he was actually very excited about this cutting edge treatment option, and equally excited that there is a 4th option to offer his future patients potentially. He is currently working on contacting Dr. [steadyhealth.com]

• Stroke

  Exclusion criteria were as follows: an left atrium diameter of ≥ 55 mm, severe left ventricular hypertrophy (LV wall thickness of ≥ 15 mm), LA thrombus, prior stroke and/or current decompensated heart failure. [medsci.org]

• Meningism

  View Article PubMed Google Scholar Bannwarth A: Chronische lymphozytäre Meningitis, entzündliche Polyneuritis and Rheumatismus. Arch Psychiatr Nervenkr. 1941, 113: 284-376. 10.1007/BF02095652. [bmcpulmmed.biomedcentral.com]

• Flank Pain

  In the operating room, he experienced a sudden onset of dyspnea, left-flank pain, chest discomfort, and anxiety. Lung sounds were diminished in the left hemithorax. He remained hemodynamically stable and oxygen saturation remained >95%. [healio.com]

He had a bronchoscopy, 2 SNIFF tests, full blood panel workup to rule autoimmune and other issues, a stress test (he was out of wind after only 3 minutes on the treadmill, but interestingly, his oxygen saturation levels stayed at 98%. [steadyhealth.com]

Conclusion Although Lyme neuroborreliosis is a rare cause of diaphragmatic weakness, it should be considered in the differential workup because of its potentially treatable nature. [bmcpulmmed.biomedcentral.com]

• Atelectasis

  "Phrenic nerve function and its relationship to atelectasis after coronary artery bypass surgery." CHEST Journal 93.4 (1988): 693-698. Benjamin, J. J., et al. [derangedphysiology.com]

  Although atelectasis, or infiltrates, or both developed in the left lower lobe of 98% of the patients (43 of 44) with or without similar changes on the right side, only 5 (11%) of the 44 patients had diaphragmatic dysfunction following operation. [ncbi.nlm.nih.gov]

  (see Atelectasis, [[Atelectasis]]) Aspiration Pneumonia Sleep-Disordered Breathing : nocturnal hypoxemia, nocturnal hypercapnia, etc Acute/Chronic Hypoventilation (see Acute Hypoventilation, [[Acute Hypoventilation]] and Chronic Hypoventilation, [[Chronic [mdnxs.com]

  Atelectasis Subpulmonic pleural effusion Congenital diaphragmatic hernia Neuromuscular disorders (e.g., muscular dystrophy, spinal muscular atrophy, Guillain-Barré syndrome). [clinicaladvisor.com]

  Surface Properties in Relation to Atelectasis and Hyaline Membrane Disease. ‎ Página 485 - In: Scriver CR, Beaudet AL, Sly WS, et al., eds. The Metabolic Basis of Inherited Disease. 6th ed. New York: McGraw-Hill; 1989. ‎ [books.google.es]

We conclude that recently developed VATS plication is a safe and effective treatment for infants with phrenic nerve palsy, and should be considered as a surgical treatment at an early period. [ncbi.nlm.nih.gov]

Prognosis is influenced by the underlying cause. Nerve function does not usually recover in cases of neoplastic involvement. [radiopaedia.org]

Prognosis The prognosis for unilateral paralysis is good, providing there is no underlying significant pulmonary or cardiac disease. Some patients recover without medical intervention. [cedars-sinai.edu]

Sex Like diaphragm eventration, diaphragm paralysis is more common among males. [9] Prognosis Unilateral diaphragmatic paralysis Depending on the etiology of the diaphragmatic paralysis, the prognosis of unilateral disease usually is excellent unless [emedicine.medscape.com]

Ventilation Rocking Bed CPAP/BiPAP Ventilator Phrenic Nerve Pacing Not usually useful (due to injured phrenic nerve/ pacing beyond site of injury is usually not possible due to atrophy of nerve) Direct pacing of muscle requires excessively high thresholds Prognosis [mdnxs.com]

Generally, there is a less favorable prognosis for those with bilateral brachial plexus palsy than for those afflicted in just one limb. [4] Phrenic nerve injury (3 rd, 4 th, 5 th cervical nerves) with diaphragmatic paralysis must be considered when cyanosis [afrjtrauma.com]

Many contributing factors have been described but the etiology of bilateral phrenic nerve palsy following open cardiac surgery still remains unclear. Raised awareness of this condition is essential. [ncbi.nlm.nih.gov]

Etiology Many cases are idiopathic or thought to be post viral 8,9. [radiopaedia.org]

If malignancy is not the cause, many times the etiology cannot be determined. [emedicine.medscape.com]

Etiology Other Acute Intermittent Porphyria (see Acute Intermittent Porphyria ) Chronic Inflammatory Demyelinating Polyneuropathy (see Chronic Inflammatory Demyelinating Polyneuropathy ) Critical Illness Polyneuropathy (see Critical Illness Polyneuropathy [mdnxs.com]

The epidemiology will therefore match that of the underlying etiology. Clearly presentation will depend on the underlying cause. In many cases of unilateral (majority of cases) phrenic nerve paralysis, patients are asymptomatic 7. [radiopaedia.org]

Epidemiology Frequency Incidence is unknown. [emedicine.medscape.com]

The epidemiology will therefore match that of the underlying etiology [ 1 ]. Most of the cases are idiopathic or even thought to be post viral. [omicsonline.org]

HIV-associated peripheral neuropathy: Epidemiology, pathophysiology and treatment. Drugs 2000;59:1251-60. 13. Huang W, Calvo M, Karu K, Olausen HR, Bathgate G, Okuse K, et al. [lungindia.com]

[…] of Neurology, University Medical Centre Goettingen, Robert-Koch-Str. 40, 37075 Goettingen, Germany (4) Department of Geriatrics, Weende Teaching Hospitals, An der Lutter 24, 37075 Goettingen, Germany References Hansen K, Lebech AM: The clinical and epidemiological [bmcpulmmed.biomedcentral.com]

It is concluded that phrenic nerve palsy might be part of the pathophysiological mechanism in strangulation and hanging, and clinical investigation to exclude diaphragm paralysis in survived cases should be considered. [ncbi.nlm.nih.gov]

and the Department of Pathophysiology, University of Athens Medical School, Athens (G.E.T.). Address reprint requests to Dr. [nejm.org]

HIV-associated peripheral neuropathy: Epidemiology, pathophysiology and treatment. Drugs 2000;59:1251-60. 13. Huang W, Calvo M, Karu K, Olausen HR, Bathgate G, Okuse K, et al. [lungindia.com]

Diaphragmatic paralysis is an uncommon, yet underdiagnosed cause of dyspnea. [3] Pathophysiology Diaphragmatic paralyses encompass a spectrum of diseases involving a single leaflet, known as unilateral diaphragmatic paralysis (UDP), and that involving [emedicine.medscape.com]

Anesth Analg 1995; 81 :962–6 [PubMed] Gibson, GJ Diaphragmatic paresis: Pathophysiology, clinical features, and investigation. [anesthesiology.pubs.asahq.org]

BACKGROUND: Electromyography-guided phrenic nerve (PN) monitoring using a catheter positioned in a hepatic vein can aid in preventing phrenic nerve palsy (PNP) during cryoballoon ablation for atrial fibrillation. [ncbi.nlm.nih.gov]