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Tuesday, March 11, 2014
What causes it? What is the effects? What is the treatment? Can it be corrected?
Many times, we do not know the cause of an elevated diaphragm. It can happen to one side (unilateral) or both sides (bilateral) and is most often caused by trauma or damage to the phrenic nerve (such as from an automobile accident or cardiac surgery). Other times, it may be caused by diseases that weaken the muscles (such as muscular dystrophy), diseases that affect the nerves going to muscles (such as polio), infection (such as Herpes Zoster), or inflammation (such as lupus). In many cases, a unilateral (on one side only) paralyzed diaphragm does not cause symptoms. In some cases, patients may notice shortness of breath with exertion or exercise, especially if they also have underlying lung disease. Treatment options are fairly limited, and are considered only in cases where shortness of breath is extremely limiting. Although the paralyzed diaphragm can not be surgically repaired (the damage is actually the result of nerve damage) directly, surgery (a procedure called "plication") may sometimes be helpful to improve the function of the diaphragm on the functioning side. Success with this procedure varies widely, and it involves significant recovery.
Jennifer McCallister, MD
Clinical Assistant Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University