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: Mahda Alihashemi M.D. [2]
Overview
The majority of patients with unilateral diaphragmatic paralysis are asymptomatic. Exertional dyspnea and decreased exercise performance are common symtoms of unilateral diaphragmati paralysis. Less common symtoms of unilateral diaphragmatic paralysis include dyspnea at rest and orthopnea. Dyspnea in supine position and orthopnea are common symtoms of bilateral diphragmatic paralysis. Less common symtoms of bilateral diaphragmatic paralysis include daytime fatigue and confusion.
History and Symptoms
History
Unilateral diaphragmatic paralysis
Patients with unilateral diaphragmatic paralysis may have a positive history of:[1]
- Childhood poliomyelitis
- Cardiac surgery in left sided paralysis
- Chest irradiation
- Injury
- Irradiation of the neck or cervical spine
Bilateral diphragmatic paralysis
Patients with bilateral diaphragmatic paralysis may have a positive history of :
- Known neuromuscular disease
Common Symptoms
Unilateral diaphragmatic paralysis:[2]
Common symtoms of unilateral diaphragmatic paralysis include:
- Usually asymptomatic at rest
- Exertional dyspnea
- Decreased exercise performance
Bilateral diaphragmatic paralysis
Less Common Symptoms
Unilateral diaphragmatic paralysis
Less common symptoms of unilateral diaphragmatic paralysis include:
- Dyspnea at rest in pateints with underlying lung disease
- Orthopnea[5]
- Disordered breathing during rapid eye movement sleep
Bilateral diaphragmatic paralysis
Less common symptoms of bilateral diaphragmatic paralysis include:[6]
- Acute supine respiratory failure[3]
- Daytime fatigue
- Morning headaches
- Confusion
References
- ↑ Piehler JM, Pairolero PC, Gracey DR, Bernatz PE (1982). "Unexplained diaphragmatic paralysis: a harbinger of malignant disease?". J. Thorac. Cardiovasc. Surg. 84 (6): 861–4. PMID 6292583.
- ↑ Hart N, Nickol AH, Cramer D, Ward SP, Lofaso F, Pride NB, Moxham J, Polkey MI (2002). "Effect of severe isolated unilateral and bilateral diaphragm weakness on exercise performance". Am. J. Respir. Crit. Care Med. 165 (9): 1265–70. doi:10.1164/rccm.2110016. PMID 11991876.
- ↑ 3.0 3.1 Sandham JD, Shaw DT, Guenter CA (1977). "Acute supine respiratory failure due to bilateral diaphragmatic paralysis". Chest. 72 (1): 96–8. PMID 872664.
- ↑ Kumar N, Folger WN, Bolton CF (2004). "Dyspnea as the predominant manifestation of bilateral phrenic neuropathy". Mayo Clin. Proc. 79 (12): 1563–5. doi:10.4065/79.12.1563. PMID 15595343.
- ↑ Laroche CM, Carroll N, Moxham J, Green M (1988). "Clinical significance of severe isolated diaphragm weakness". Am. Rev. Respir. Dis. 138 (4): 862–6. doi:10.1164/ajrccm/138.4.862. PMID 3202460.
- ↑ Qureshi A (2009). "Diaphragm paralysis". Semin Respir Crit Care Med. 30 (3): 315–20. doi:10.1055/s-0029-1222445. PMID 19452391.