Diaphragmatic paralysis history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
The majority of patients with [disease name] are asymptomatic.
OR
The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
History and Symptoms
Patients with unilateral diaphragmatic paralysis are usually asymptomatic at rest, but may have exertional dyspnea and decreased exercise performance [9,14]. However, patients with underlying or intercurrent lung disease may experience dyspnea at rest. Orthopnea can also occur, but is not as intense as with bilateral diaphragmatic paralysis [7,15]. Unilateral diaphragm paralysis may also be associated with sleep-disordered breathing during rapid eye movement sleep [16].
Patients are asked about any history of childhood poliomyelitis, cardiac surgery (especially if the paralysis is left-sided), or chest irradiation and also pain, injury, manipulation, surgery, or irradiation of the neck or cervical spine (table 1).
If lung disease develops (eg, asthma, pneumonia, COPD, lung fibrosis), the increase in load may fatigue the already overburdened accessory muscles, leading to symptoms and signs of ventilatory failure. Respiratory insufficiency in this setting is often reversible, particularly if the lung injury is reversible (asthma attack, COPD exacerbation or pneumonia). In case of progressive lung disease, the symptoms may persist requiring long-term ventilator support. (See "Respiratory muscle weakness due to neuromuscular disease: Clinical manifestations and evaluation", section on 'Clinical manifestations'.)
- The majority of patients with [disease name] are asymptomatic.
OR
- The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
- Symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
History
Patients with diaphragmatic paralysis may have a positive history of:[1]
- Childhood poliomyelitis
- Cardiac surgery in left sided paralysis
- Chest irridation
- Injury
- Irradiation of the neck or cervical spine
Common Symptoms
Common symptoms of unilateral diaphragmatic paralysis include:
- Usually asymptomatic at rest
- Exertional dyspnea
- Decreased exercise performance
Less Common Symptoms
Less common symptoms of include
- [Symptom 1]
- [Symptom 2]
- [Symptom 3]