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Neurology (Expert Forum)
Bilateral Diaphragm Paralysis without trauma or surgery
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Bilateral Diaphragm Paralysis without trauma or surgery
by bzy_lady, Jul 13, 2005 12:00AM
My husband is 50 years old. About 3 months ago, he went to bed one night and couldn't breathe when he laid down. After a few days in our local hospital he was transferred to UVA in Charlottesville and was diagnosed with bilateral diaphragm paralysis (i'm not sure if there is a more technical name for this). None of the doctors who have worked on his case had ever seen this. He has always been healthy, never missed a days work in 30 years and hadn't been to a doctor in 35 years. The doctors tell us that he evidentally had a virus that his antibodies attacked, then the anntibodies became confused and attacked his phrenic nerves. The only treatment he is taking is a bipap machine at night while he sleeps. We are told that whatever recovery these nerves make in the next year will be as good as it gets. Evidentally there have only been 18 cases of this in the past decade. He feels fine while sitting around but has labored breathing when he tries to use the pectorial and/or abdominal muscles for everyday lifting, after meals and still cannot lay flat in bed. He sleeps with a bed wedge and the breathing machine. Unfortunately, he is a self-employed carpenter so this has left him unable to work. He can't even carry our 1 year old baby very far. My question is has anyone treated this, what was the success rate and is there anything else we can do but sit and wait. I've read that antioxidants have been tested as a means aid healing nerves and was wondering if chiropractic care could help. Thank you.
Doctor's Answer
by CCF-Neuro-M.D.-PW, Jul 13, 2005 12:00AM
It is indeed a rare condition, but known to occur. I cannot comment on the accuracy of their diagnosis, without knowing the exam and test results so my advice is limited. I assume other causes of phrenic nerve injury were excluded - neuralgic amyotrophy, trauma, tumor etc.
If it was an immune system attack, the only specific treatment is partially effective within 2-4 weeks of teh attack (plasmapheresis or IV immunoglobulin). After this one has to wait for the nerve to recover itself. There are no scientifically proven ways to speed or increase the nerve healing as yet, although there is much research being done in this area. EMG can give an idea about extent of recovery, but this is difficult and dangerous with the diaphragm muscles. Sometimes a diaphragmatic stimulator can be impanted to stimulate the diaphragms to move (like a pacemaker) - your husband may be a candidate for this. Chiropractic care is not scientiffically or medically proven to help. Maintaining good fitness of his other muscles will be important though.
Good luck
If it was an immune system attack, the only specific treatment is partially effective within 2-4 weeks of teh attack (plasmapheresis or IV immunoglobulin). After this one has to wait for the nerve to recover itself. There are no scientifically proven ways to speed or increase the nerve healing as yet, although there is much research being done in this area. EMG can give an idea about extent of recovery, but this is difficult and dangerous with the diaphragm muscles. Sometimes a diaphragmatic stimulator can be impanted to stimulate the diaphragms to move (like a pacemaker) - your husband may be a candidate for this. Chiropractic care is not scientiffically or medically proven to help. Maintaining good fitness of his other muscles will be important though.
Good luck
Thanks in advance for your help.