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Respiratory Disorders (Expert Forum)
Phrenic Nerve Palsy and displacement of the diaphragm
Answered by
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Phrenic Nerve Palsy and displacement of the diaphragm
by Billrg, Jun 18, 2003 12:00AM
My 12 yr old son had surgery in March, 2000. Last summer, he developed pnuemonia (pneumonia) and was seen by a pediatric pulmonologist. the chest x-rays showed the right side of his diaphragm was higher than the left. During the course of treatment, no change was noted as the pnuemonia (pneumonia) cleared. He contracted pnuemonia (pneumonia) again this spring. The chest xray showed the diaphragm had displaced even higher into the lung field, restricting the lung to approximately 30% capacity, with the lower lobes apprearing to be non-functioning. He is also pardoxically breathing in the right. The diagnosis from the pulmonologist was right phrenic nerve palsy as the instigator of all of this. He is now also being treated for asthma (which he didn't have prior to all of this). He was to have surgery to put the diaphragm "back into place", (thoracotomy incision with a mesh to hold the diaphragm in place) but the surgery has been pushed back 6 months to get the asthma controlled. His current medical regime consists of adviar 250/50 bid, singulair 10 mg qd, maxair prn, xopenex 1.25mg prn tid, and is using a cough assist machine to help keep his lungs as clear as possible. Is there any way medically to return the diaphragm to it's position? What other course of treatment are suggested? The pulmonologist and the surgeon have not encountered this situation before. Thanks.
Doctor's Answer
by National Jewish, Jun 23, 2003 12:00AM
, Jun 23, 2003 12:00AM
The most common cause of paralysis to one side of the diaphragm is trauma to the phrenic nerve that may occur along with surgery. This is the nerve that normally stimulates the diaphragm to move. When the diaphragm doesn’t move, it is effectively treated by a surgical procedure called diaphragmatic plication. I believe that is what your son's doctors are suggesting.
A second opinion consultation for your son would answer your question about other courses of treatment. A specialist at a university medical center or children’s hospital is most likely to have the greatest experience in evaluating and treating children with a paralyzed diaphragm.
A second opinion consultation for your son would answer your question about other courses of treatment. A specialist at a university medical center or children’s hospital is most likely to have the greatest experience in evaluating and treating children with a paralyzed diaphragm.
Member Comments (1)
by EmJa, Feb 13, 2009 01:58PM
A related discussion, paralyzed diaphram was started.
