What are the signs and symptoms of bilateral diaphragmatic paralysis?

Updated: Oct 10, 2018
  • Author: Justina Gamache, MD; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Patients typically present with respiratory failure or dyspnea (should be distinguished from right-sided heart failure [fluid retention and dyspnea]) that worsens in the supine position. [1] Tachypnea and rapid, shallow breathing occur when the patient adopts the recumbent position.

Patients also report anxiety, insomnia, morning headache, excessive daytime somnolence and fatigue, and poor sleep habits. In some patients, nonspecific GI symptoms such as heartburn, regurgitation, nausea, and epigastric pain can also develop. [9]

In bilateral diaphragmatic paralysis, additional clues to diagnosis include dyspnea further exacerbated in a swimming pool or sleep that only occurs in the sitting position. The duration of symptoms prior to diagnosis can be quite long because of a lack of suspicion for the condition.

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