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Clinical and Translational Neuroscience is published by MDPI from Volume 5 Issue 2 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with SAGE.
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Case Report

Bilateral Phrenic Neuropathy Responsive to Intravenous Immunoglobulin Treatment

by
Paolo Ripellino
1,*,
Marco Pons
2,
Mikael Gian Andrea Izzo
1 and
Claudio Gobbi
1
1
Department of Neurology, Neurocenter of Southern Switzerland, 6900 Lugano (CH), Switzerland
2
Department of Internal Medicine, Ospedale Regionale di Lugano, 6900 Lugano (CH), Switzerland
*
Author to whom correspondence should be addressed.
Clin. Transl. Neurosci. 2019, 3(2), 20; https://doi.org/10.1177/2514183x19891606
Submission received: 19 July 2019 / Accepted: 7 November 2019 / Published: 29 December 2019
Versions Notes

Abstract

The aetiology of phrenic neuropathy is often unknown, but immune mechanisms may play a role. In a typical case of bilateral phrenic neuropathy with paradoxical breathing (video), an inflammatory pathogenesis was suggested by prolonged distal latency of phrenic nerve compound muscle action potentials in nerve conduction studies and a clear-cut albumin-cytologic dissociation. This encouraged us to treat the patient with a standard dose of intravenous immunoglobulin. After obtaining a strong improvement at spirometry, we repeated the second cycle of intravenous immunoglobulin and observed normalization of symptoms within few weeks and no relapse after 3 years. This case suggests that lumbar puncture should be performed in the acute phase of phrenic neuropathies to detect potential responders to immunomodulatory treatment.
Keywords: lumbar puncture; bilateral phrenic neuropathy; immunoglobulin; paradoxical breathing lumbar puncture; bilateral phrenic neuropathy; immunoglobulin; paradoxical breathing

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MDPI and ACS Style

Ripellino, P.; Pons, M.; Izzo, M.G.A.; Gobbi, C. Bilateral Phrenic Neuropathy Responsive to Intravenous Immunoglobulin Treatment. Clin. Transl. Neurosci. 2019, 3, 20. https://doi.org/10.1177/2514183x19891606

AMA Style

Ripellino P, Pons M, Izzo MGA, Gobbi C. Bilateral Phrenic Neuropathy Responsive to Intravenous Immunoglobulin Treatment. Clinical and Translational Neuroscience. 2019; 3(2):20. https://doi.org/10.1177/2514183x19891606

Chicago/Turabian Style

Ripellino, Paolo, Marco Pons, Mikael Gian Andrea Izzo, and Claudio Gobbi. 2019. "Bilateral Phrenic Neuropathy Responsive to Intravenous Immunoglobulin Treatment" Clinical and Translational Neuroscience 3, no. 2: 20. https://doi.org/10.1177/2514183x19891606

APA Style

Ripellino, P., Pons, M., Izzo, M. G. A., & Gobbi, C. (2019). Bilateral Phrenic Neuropathy Responsive to Intravenous Immunoglobulin Treatment. Clinical and Translational Neuroscience, 3(2), 20. https://doi.org/10.1177/2514183x19891606

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