Diaphragmatic diseases are rare diseases in the society. These diseases, which are usually asymptomatic, may occur incidentally in cases where other diseases are suspected. Diaphragmatic disordersoften present themselves with respiratory problems.
Diaphragmatic paralysis is one of these diseases. So what is diaphragmatic paralysis, and what are its symptoms, diagnostic methods, and treatment? We tried to answer all these questions about diaphragm paralysis in this text
What is Diaphragm Paralysis?
The structure that separates the abdominal and thoracic cavities and assists the muscular system and respiratory movements is called the diaphragm.
Any problem that may occur in the diaphragm can cause many dysfunctions, especially affecting respiratory functions. Problems with the diaphragm can be congenital or acquired. Problems that may occur with the diaphragm are as follows:
- Congenital diaphragmatic hernia,
- A traumatic diaphragmatic hernia that may develop due to gunshot or knife injuries,
- Gastric hernia,
- Diaphragm tumor,
- Diaphragm paralysis.
So what is diaphragmatic paralysis, and why does it happen?
The nerve, particularly the phrenic nerve, that controls the movements of the diaphragm is injured, leading to paralysis of one or both sides of the diaphragm. It can lead to severe breathing problems. The most common causes of diaphragmatic paralysis are listed as follows:
- Surgical traumas,
- Lymph or lung cancer causing compression of the phrenic nerves,
- neuromuscular disorders such as MS or ALS,
- Spinal cord or phrenic nerve injuries.
Although diaphragmatic paralysis is rare, early diagnosis and treatment are life-saving.
Symptoms and Diagnostic Methods of Diaphragmatic Paralysis
Some of the symptoms may indicate diaphragmatic paralysis or other diseases. The most common symptoms of diaphragm paralysis are shortness of breath while resting, lying on your back, or swimming.
The doctor first listens to the patient's history and performs a physical examination to diagnose the disease. If diaphragmatic paralysis is suspected, there are seven tests for a definitive diagnosis. These tests can be listed as follows:
- Chest X-ray: The spine, chest area, heart, blood vessels, bones, and airways are displayed.
- Computed Tomography: This shows the thoracic cavity in detail.
- Ultrasound: Irregularities in diaphragm functions are detected.
- Arterial Blood Gas: It controls the amount of oxygen, acid, and carbon dioxide in the blood.
- Pulmonary Function Tests: Checks the respiratory functions.
- Electromyography (EMG): Measures the function of nerves to send electrical signals.
- Phrenic Nerve Stimulation Test:Phrenic Nerve Stimulation Test: The electrical potential of muscle fibers is measured.
Commonly used tests for diagnosing diaphragmatic paralysis are ultrasound, phrenic nerve stimulation, and electromyography.
Treatment of Diaphragmatic Paralysis
Intervention is avoidable when patients do not have any symptoms or complaints or have no findings.
However, surgical intervention may be necessary in cases where the diaphragm retracts into the chest cavity. This surgical procedure, called diaphragmatic plication, prevents the paralyzed diaphragm from being pulled into the chest cavity during breathing.
Placing a battery on the diaphragm is also widely applied in recent years. This method puts a battery on the diaphragm by surgically entering the abdominal or thoracic cavity. With this battery, we can provide the movement of the diaphragm.
In advanced cases, we can provide respiratory support in addition to the treatments applied. The doctor decides on the most appropriate treatment method after the examinations.