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Posted by CCF Neuro MD on August 13, 1997 at 20:30:41:
In Reply to: breathing difficulty - muscle weakness? posted by Ellen O. on July 18, 1997 at 00:17:51:
: I've been having constant progressive breathing weakness. It's difficult
to generate force to my breathing. When I describe it to my pulmonologist,
he says my descriptions (like breathing through a straw with holes in it,
trying to blow up a balloon that's already full) sound like the descriptions
he's heard from patients with neuromuscular problems. However, my neuro exam
is normal for neuromuscular disease. Also, the doctors have observed that I
have less movement of my chest and abdomen when I take breaths. Are there
other things that could affect the elasticity of muscles? I've been wondering
about blood supply. My problem seems to be isolated in my torso. I could
walk forever if only I could breathe right. But as it is, it's now difficult
to walk and talk at the same time. I have a history of surgeries, so maybe
adhesions are working their magic in there! Are there cases of partial spinal
injuries causing such difficulty? I do have a congenital fusion of my C-spine
which we haven't looked closely at yet. Any ideas as to what I might
ask my doctors to look into? Thanks...
Yours is an interesting problem. Ventilatory weakness from neuromuscular cause can have a variety of somewhat uncommon causes. In the presence of a relatively normal neurological examination, the list would be much shorter. I can think of bilateral diaphragmatic paralysis, myasthenia gravis, myotonic dystrophy, and glycogen storage disease as some of the potential few causes where the diagnosis is not obvious to the physician. There are several tests that are helpful in srting this out, the important ones being some blood tests, pulmonary function tests (spirometry) and the EMG. Undoubtedly, you pulmonologist and neurologist have thought on similar lines.
In case you live in the Cleveland area and desire a second opinion, you are welcome to see one of the neuromuscular specialists at the Cleveland Clinic. Dr. Mitsumoto, Dr. Shields, Dr. Levin, Dr. Pioro, and Dr. Wilbourn are renowned nationally and internationally for the work in this subspeciality of neurology. The number to call for appointments is (216)444-5559, or (800)223-2273 toll free.
I wish you the best of luck.
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