Premium Nahrungsergänzungsmittel | artgerecht

Diaphragm Paresis – Causes, Symptoms and Treatment

Diaphragm paresis is a partial or complete paralysis of the diaphragm, the main breathing muscle, which can significantly impair respiratory function. It is most commonly caused by nerve damage.

Regular tips about health Regular tips about health

Things worth knowing about "Diaphragm Paresis"

Diaphragm paresis is a partial or complete paralysis of the diaphragm, the main breathing muscle, which can significantly impair respiratory function. It is most commonly caused by nerve damage.

What Is Diaphragm Paresis?

Diaphragm paresis refers to a partial (paresis) or complete (paralysis) loss of function of the diaphragm, the dome-shaped muscle that separates the chest cavity from the abdominal cavity and serves as the primary muscle of breathing. With each breath, the diaphragm contracts downward to expand the lungs. When this muscle is weakened or paralyzed, breathing can become significantly compromised.

The condition may affect one side of the diaphragm (unilateral) or both sides (bilateral). Bilateral diaphragm paresis is considerably more serious and can lead to severe respiratory failure.

Causes

Diaphragm paresis is most commonly caused by damage to the phrenic nerve, which is the primary nerve controlling the diaphragm. Known causes include:

Traumatic injury: Surgeries involving the neck, chest, or heart, as well as accidents or penetrating wounds
Neurological diseases: Amyotrophic lateral sclerosis (ALS), multiple sclerosis, poliomyelitis, or Guillain-Barre syndrome
Malignancies: Lung cancer, lymphomas, or other tumors that compress or infiltrate the phrenic nerve
Infectious causes: Viral neuritis, such as following herpes zoster infection
Idiopathic causes: In a proportion of cases, no identifiable cause is found
Birth trauma: Phrenic nerve injury during difficult delivery in newborns

Symptoms

Symptoms vary depending on whether one or both sides of the diaphragm are affected:

Unilateral Diaphragm Paresis

Often mild or asymptomatic
Exertional dyspnea (shortness of breath during physical activity)
Incidental finding on chest X-ray (elevated hemidiaphragm)
Mild reduction in lung capacity

Bilateral Diaphragm Paresis

Severe breathlessness, particularly when lying flat (orthopnea)
Hypoxia (low blood oxygen levels)
Hypercapnia (elevated carbon dioxide levels in the blood)
Sleep-disordered breathing
In severe cases: acute respiratory failure

Diagnosis

Several diagnostic tools are used to evaluate diaphragm paresis:

Chest X-ray: Reveals an elevated hemidiaphragm on the affected side
Ultrasound: Real-time assessment of diaphragm movement and thickness
Fluoroscopy (sniff test): Detects paradoxical upward movement of the diaphragm during rapid inhalation
Pulmonary function testing (spirometry): Measures lung volumes and detects restrictive breathing patterns
Electromyography (EMG) and nerve conduction studies: Assess phrenic nerve function
MRI or CT scan: Identifies structural causes such as tumors or nerve compression

Treatment

Treatment of diaphragm paresis depends on the underlying cause, the severity of respiratory impairment, and the overall health of the patient.

Conservative Management

Treatment of the underlying condition (e.g., oncological therapy, antiviral medications)
Respiratory physiotherapy to strengthen accessory breathing muscles
Weight management, as excess body weight can worsen symptoms

Ventilatory Support

Non-invasive ventilation (NIV): Particularly beneficial in bilateral paresis with nocturnal hypoventilation
Invasive mechanical ventilation: Reserved for severe acute respiratory failure

Surgical Options

Diaphragm plication: Surgical tightening of the paralyzed diaphragm to improve breathing mechanics
Diaphragm pacing: Electrical stimulation of the phrenic nerve in selected patients

Prognosis

The outlook for diaphragm paresis depends largely on the underlying cause. Traumatically induced paresis may partially or fully resolve over time. Paresis associated with progressive neurological diseases generally carries a poorer prognosis. Regular medical follow-up and appropriate ventilatory support can significantly improve quality of life for affected individuals.

References

McCool F.D., Tzelepis G.E. - Dysfunction of the Diaphragm. New England Journal of Medicine, 2012; 366:932-942.
Ricoy J. et al. - Diaphragmatic dysfunction. Pulmonology, 2019; 25(4):223-235.
Boon A.J. et al. - Two-dimensional ultrasound imaging of the diaphragm: quantitative values in normal subjects. Muscle and Nerve, 2013; 47(6):884-889.

Building Blocks for a Healthy Life

As an integrated manufacturer, we develop & produce evidence-based, patented, and non-patented formulations. We work exclusively with plant and natural extracts according to the strictest purity & quality standards.
The combination of science & modern technology with the laws of nature creates solutions consistently tailored to humans – for the highest good: health.

Most read entries

3 Posts in this encyclopedia category