Phrenic neuropathy and diaphragm dysfunction in neuralgic amyotrophy
| Autor: | Peter J. Wijkstra, Michael A. Gaytant, Yvonne F. Heijdra, Roy T.M. Sprooten, Jonne Doorduin, Marieke H. Van Rosmalen, Nens van Alfen, Jeroen J.J. van Eijk, Andrea J. Boon, Ries J. M. van den Biggelaar, Jan T. Groothuis |
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| Přispěvatelé: | UCM Scientific staff, RS: FSE UCM, Pulmonologie, MUMC+: MA Med Staf Spec Longziekten (9), RS: FSE, Intensive Care, Pulmonary Medicine |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Orthopnea Supine position Adolescent Phrenic neuropathy medicine.medical_treatment Diaphragm Diaphragmatic breathing DIAGNOSIS Cohort Studies Young Adult 03 medical and health sciences 0302 clinical medicine Brachial Plexus Neuritis Humans Medicine 030212 general & internal medicine Young adult Aged Netherlands Mechanical ventilation business.industry Other Research Radboud Institute for Health Sciences [Radboudumc 0] Recovery of Function Middle Aged Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] Respiration Artificial Respiratory Paralysis Diaphragm (structural system) Phrenic Nerve Inflammatory diseases Radboud Institute for Health Sciences [Radboudumc 5] Female Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery Cohort study |
| Zdroj: | Neurology, 91(9), E843-E849. LIPPINCOTT WILLIAMS & WILKINS Neurology, 91, 9, pp. e843-e849 Neurology, 91, e843-e849 Neurology, 91(9), E843-E849. Lippincott Williams & Wilkins |
| ISSN: | 1526-632X 0028-3878 |
| DOI: | 10.1212/wnl.0000000000006076 |
| Popis: | ObjectiveTo describe the clinical phenotype and recovery of diaphragm dysfunction caused by neuralgic amyotrophy in a large cohort of patients, to improve accurate awareness of this entity, and to encourage adoption of a standardized approach for diagnosis and treatment.MethodsThis observational cohort study recruited adult patients with neuralgic amyotrophy and symptoms of idiopathic phrenic neuropathy from the database of the Dutch expert center for neuralgic amyotrophy and the Dutch centers for home mechanical ventilation. Demographic and clinical information on diagnosis, symptoms, and recovery was obtained from chart review. We attempted to contact all patients for a follow-up interview.ResultsPhrenic neuropathy occurs in 7.6% of patients with neuralgic amyotrophy. Unilateral diaphragmatic dysfunction and bilateral diaphragmatic dysfunction are frequently symptomatic, causing exertional dyspnea, orthopnea, disturbed sleep, and excessive fatigue. Diagnostic practices varied widely and were often not optimally targeted. The majority of patients experienced at least moderate recovery within 2 years.ConclusionWe recommend screening every patient with neuralgic amyotrophy for diaphragm dysfunction by asking about orthopnea and by performing upright and supine vital capacity screening and diaphragm ultrasound in cases of suspected phrenic neuropathy to optimize diagnosis and care. |
| Databáze: | OpenAIRE |
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