[An unusual cause of acute dyspnoea: neuralgic amyotrophy].

[neuralgic amyotrophy]

A 40 -year -old man presented at the neurology outpatient clinic with sudden severe pain in both shoulders , followed by paresis of the muscles in this region . These complaints , in combination with acute dyspnoea when lying flat , and paradoxal movements of the abdomen during respiration , led to the diagnosis of neuralgic amyotrophy with phrenic nerve involvement . A 43 -year -old man was seen on the pulmonary unit with severe pain in the shoulder area , followed by acute severe dyspnoea , worsening when he lay flat . Lung function analysis showed severe restriction and decreased maximal inspiratory mouth pressure . Taking into account the pain in the shoulder in combination with decreased inspiratory mouth pressure suggestive of diaphragmatic paresis , isolated neuralgic amyotrophy with phrenic nerve involvement was diagnosed . As these cases demonstrate , the diagnosis 'neuralgic amyotrophy with phrenic nerve involvement ' often can be determined by history taking and physical examination . Unfamiliarity with this condition may lead to severe delay in the diagnostic process and to unnecessary investigations , especially when no accompanying paresis of the shoulder girdle and arm musculature is present .