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Respiratory Disorders (Expert Forum)
phrenic nerve /diaphragm paralysis
Answered by
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phrenic nerve /diaphragm paralysis
by noran, Jul 01, 2006 12:00AM
I suffered a T1 spinus process fracture 15 months ago,Xray showed a slightly raised right hemi diaphragm, a sniff test (screening)showed the right hemi diaphragm did not move but there was not true paradoxical movement, also my report said i do not have true paradoxical movement of the hemi diaphragm which suggests that there is not complete paralysis. The cause of my injury was having my neck twisted/pulled sharply to the right . My physician says my phrenic nerve at the time of fall suffered a injury and was probably a neurotmnetic injury.He says this should slowly improve with time (the phrenic nerve will repair).My concern at the moment is my lack of stamina due to reduced lung capacity ( my FEV1 was 3.4 of a litre with a peak flow of 520 i am a 42 year old male ) as before the accident i was a keen runner . Would you agree with this report,and i am confussed with the wording ( is it paralysed or not).
Also is it possible for the phrenic nerve to be pinched/touched by a T1 spinus process fracture or is it not near this area as iv'e got in my head the continueing discomfit around my neck and shoulders and paralysed diaphragm are being caused by the bone.Look forward to any comments.Thankyou.
Also is it possible for the phrenic nerve to be pinched/touched by a T1 spinus process fracture or is it not near this area as iv'e got in my head the continueing discomfit around my neck and shoulders and paralysed diaphragm are being caused by the bone.Look forward to any comments.Thankyou.
Doctor's Answer
by National Jewish, Jul 07, 2006 12:00AM
, Jul 07, 2006 12:00AM
The sniff test is a fairly reliable indicator of diaphragmatic paralysis. However it is not full proof. Phrenic nerve stimulation in the neck with measurement of phrenic nerve latency can be used to make a definitive diagnosis of phrenic nerve dysfunction as the cause of hemi-diaphragmatic paralysis. This is a rather specialized test usually done by a neurologist. It is fairly reliable, especially when combined with fluoroscopy. You should seek consultation with a neurologist who has an interest in electrophysiological nerve testing.
Damage to the phrenic nerve is more likely to occur with trauma to the cervical than to the thoracic (T1) spine, but the damage can occur without a demonstrated fracture. Recovery is usually spontaneous, but can take a long time. The chance of recovery after 15 months is not good.
Your assumption that the continuing pain is caused "by the bone" may or may not be correct. It could just as easily be caused by the development of chronic neuritis due to the trauma.
Damage to the phrenic nerve is more likely to occur with trauma to the cervical than to the thoracic (T1) spine, but the damage can occur without a demonstrated fracture. Recovery is usually spontaneous, but can take a long time. The chance of recovery after 15 months is not good.
Your assumption that the continuing pain is caused "by the bone" may or may not be correct. It could just as easily be caused by the development of chronic neuritis due to the trauma.
I had severe neck pain and pain in my left upper quadrant...near and up under my rib cage it seemed. Prior, I also had coughing and was treated for pneumonia and my right lower lung had collapsed. I had/have exteme difficulty laying flat on my back. I'm just wondering if others have had the difficulty in being diagnosed and what further optins they have had. It has seemed to me hopeless in geting any further understanding, treatment, from my DR. It seems I have no way of making them understand the "difficulty in breating" the "shortness of breath" the discomfort. Does this affect in some way the inner thorasic pressure???? Im just desperately trying to get some help, knowledge, advice? I need information to get to a pulmonologist or neurologist????? Thanks.
My plumonologist also told me there is nothing that can be done. If anyone out there could give me some advice on where to go from here I would really appreciate it. I refuse to believe there is nothing that can be done. Phrenic nerve damage happens often in open heart surgery there must be specialists that can help Thanks
My plumonologist also told me there is nothing that can be done. If anyone out there could give me some advice on where to go from here I would really appreciate it. I refuse to believe there is nothing that can be done. Phrenic nerve damage happens often in open heart surgery there must be specialists that can help Thanks