Bilateral phrenic nerve paralysis manifested by orthopnea for 6 months in a patient with neuralgic amyotrophy.

[neuralgic amyotrophy]

Bilateral phrenic nerve paralysis (BPP ) is a relatively rare disease manifested by slight dyspnea at rest and on exertion in the sitting and standing positions and by dyspnea in the supine position . A 67 -year -old man , who was a painter , presented with severe pain in both shoulder regions that had evolved into orthopnea and forced him to sleep in a sitting position at night . Dyspnea and paradoxical respiratory movement in the supine position raised suspicions of BPP . The most striking feature in this case was that the rapid onset of pain in both shoulder regions was followed by BPP . The BPP was considered to be secondary to neuralgic amyotrophy (NA ).