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Diaphragmatic Palsy

by Laxmi Kokatnur 1,2,3,* and Mohan Rudrappa 4,5,6,*
1
Department of Neurology, Louisiana State University Health Science Center, 1501 Kings Highway, Shreveport, LA 711031, USA
2
Department of Neurology, Overton Brooks VA Medical Center, 501 E Stoner Ave, Shreveport, LA 71101, USA
3
Department of Neurology, Mercy Hospital, 100 Mercy Way, Joplin, MO 64804, USA
4
Department of Pulmonary and Critical Care Medicine, Louisiana State University Health Science Center, 1501 Kings Highway, Shreveport, LA 711031, USA
5
Department of Pulmonary and Critical Care Medicine, Overton Brooks VA Medical Center, 501 E Stoner Ave, Shreveport, LA 71101, USA
6
Department of Pulmonary and Critical Care Medicine, Mercy Hospital, 100 Mercy Way, Joplin, MO 64804, USA
*
Authors to whom correspondence should be addressed.
Diseases 2018, 6(1), 16; https://doi.org/10.3390/diseases6010016
Received: 22 December 2017 / Revised: 11 February 2018 / Accepted: 12 February 2018 / Published: 13 February 2018
The diaphragm is the primary muscle of respiration, and its weakness can lead to respiratory failure. Diaphragmatic palsy can be caused by various causes. Injury to the phrenic nerve during thoracic surgeries is the most common cause for diaphragmatic palsy. Depending on the cause, the symptoms of diaphragmatic palsies vary from completely asymptomatic to disabling dyspnea requiring mechanical ventilation. On pulmonary function tests, there will be a decrease in the maximum respiratory muscle power. Spirometry shows reduced lung functions and a significant drop of lung function in supine position is typical of diaphragmatic palsy. Diaphragmatic movements with respiration can be directly visualized by fluoroscopic examination. Currently, this test is being replaced by bedside thoracic ultrasound examination, looking at the diaphragmic excursion with deep breathing or sniffing. This test is found to be equally efficient, and without risks of ionizing radiation of fluoroscope. Treatment of diaphragmatic palsy depends on the cause. Surgical approach of repair of diaphragm or nonsurgical approach of noninvasive ventilation has been tried with good success. Overall prognosis of diaphragmatic palsy is good, except when it is related to neuromuscular degeneration conditions. View Full-Text
Keywords: diaphragmatic palsy; phrenic nerve injury; respiratory failure; pulmonary function tests diaphragmatic palsy; phrenic nerve injury; respiratory failure; pulmonary function tests
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Kokatnur, L.; Rudrappa, M. Diaphragmatic Palsy. Diseases 2018, 6, 16.

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