J Electrodiagn Neuromuscul Dis.  2021 Dec;23(3):89-93. 10.18214/jend.2021.00073.

Unilateral Phrenic Nerve Palsy Following Blunt Chest Trauma: A Case Report

• Roh CH
• Won YH

• KMID: 2526158
• DOI: http://doi.org/10.18214/jend.2021.00073

Abstract

Phrenic nerve injury without a direct injury is unusual and difficult to diagnose. This case report is the first to describe the diagnosis of unilateral phrenic nerve palsy following blunt chest trauma by fluoroscopic diaphragmatic movement testing and electrodiagnostic testing. A 68-year-old man was admitted to the emergency department after a motorcycle accident. Chest radiography showed an elevated right hemidiaphragm. More than 7 months later, he experienced dyspnea on exertion and orthopnea, prompting him to visit the Department of Rehabilitation Medicine. Fluoroscopic diaphragmatic movement testing showed no movement in the right diaphragm during maximum inspiration and expiration, but the left diaphragm was intact. Electrodiagnostic testing showed absent compound motor action potential (CMAP) in the right diaphragm, but normal CMAP in the left diaphragm. We hypothesize that in patients with orthopnea symptoms after blunt chest trauma, electrodiagnostic testing paired with fluoroscopic diaphragmatic movement testing may be useful for diagnosing diaphragm palsy.

Keyword

Phrenic nerve palsy; Blunt trauma; Fluoroscopic test