J Korean Pediatr Soc.  1998 Apr;41(4):553-557.

A Case of Unilateral Diaphragmatic Paralysis with Brachial Plexus Palsy in the Neonate

• Yoon HJ
• Park KH
• Kim SH
• Seul KW
• Kim GH
• Lee HS
• Lim CY

Abstract

The diaphragm is especially important in sustaining minute ventilation in the neonate. Consequently, diaphragmatic paralysis is not tolerated well by the neonate and often results in prolonged respiratory failure. We experienced a case of unilateral diaphragmatic paralysis with the brachial plexus palsy in a male newborn infant who presented with apnea and cyanosis due to birth asphyxia. After endotracheal intubation, mechanical ventilaton was started. At two weeks after therapy, chest X-ray showed atelectasis and elevation of the right hemidiaphragm. The diagnosis of unilateral diaphragmatic paralysis was confirmed by real-time ultrasonography. At 4 weeks old, after several unsuccessful attempts at weaning from ventilatory support, right hemidiaphragm was plicated. On the second postoperative day, he could be weaned from ventiatory support without difficulty. He was doing well at follow-up 3 months later.

Keyword

Diaphragmatic paralysis; Brachial plexus palsy; Plication of diaphragm

MeSH Terms

Apnea
Asphyxia
Brachial Plexus*
Cyanosis
Diagnosis
Diaphragm
Follow-Up Studies
Humans
Infant, Newborn*
Intubation, Intratracheal
Male
Paralysis*
Parturition
Pulmonary Atelectasis
Respiratory Insufficiency
Respiratory Paralysis*
Thorax
Ultrasonography
Ventilation
Weaning