Phrenic Nerve Palsy and displacement of the diaphragm
My 12 yr old son had surgery in March, 2000. Last summer, he developed pnuemonia 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 cleared. He contracted pnuemonia 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.
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
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