Bilateral phrenic nerve paralysis manifested by orthopnea for 6 months in a patient with neuralgic amyotrophy.
Bilateral phrenic nerve paralysis (BPP) is a relatively rare disease manifested by slight dyspnea at rest and on exertion in the sitting and standing positions and by dyspnea in the supine position. A 67-year-old man, who was a painter, presented with severe pain in both shoulder regions that had evolved into orthopnea and forced him to sleep in a sitting position at night. Dyspnea and paradoxical respiratory movement in the supine position raised suspicions of BPP. The most striking feature in this case was that the rapid onset of pain in both shoulder regions was followed by BPP. The BPP was considered to be secondary to neuralgic amyotrophy (NA).
Ikegami
Gaku
G
Department of Respiratory Medicine, Dokkyo Medical University Koshigaya Hospital, Koshigaya. ikegami@dokkyomed.ac.jp
Abe
Tokuro
T
Akasaka
Keiichi
K
Kouyama
Akemi
A
Souma
Ryosuke
R
Matsuo
Takashi
T
Kouyama
Kenya
K
Fujiwara
Hiroki
H
Ichiwata
Toshio
T
Nagao
Koshu
K
D000368:Aged; D020968:Brachial Plexus Neuritis / Q000150:complications*; D004417:Dyspnea / Q000209:etiology*; D006801:Humans; D008297:Male; D010243:Paralysis / Q000150:complications* / Q000175:diagnosis; D010791:Phrenic Nerve; D012129:Respiratory Function Tests; D012133:Respiratory Paralysis / Q000209:etiology*; D016683:Supine Position