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Diaphragmatic paralysis is a condition that causes the diaphragm, the primary organ used for breathing, to lose the ability to work properly. Depending on the amount of immobility, respiration can become labored and severely impaired. In severe cases respiratory function can break down or stop.
Located in the trunk just under the ribs, the diaphragm is a curved layer of muscles separating the chest and the stomach. Its primary function is to allow the lungs to contract and expand when air in drawn into the body. The diaphragm also aids in removing waste products and preventing acid reflux.
The most common cause of diaphragmatic paralysis is cancer, especially of the lungs. Certain health conditions, such as herpes zoster and degeneration or injury of the spinal bones in the neck area may also trigger full or partial immobility of this muscle grouping. Occasionally there is no medical explanation of paralysis.
The diaphragm can demonstrate an inability to move in just a section of its muscles. Referred to as unilateral paralysis, this health condition can present with mild symptoms such as shortness of breath with physical exertion or when laying flat, a condition called orthopnea. Dyspnea or difficulty breathing can be present with bilateral diaphragmatic paralysis. When the entire diaphragm is involved associated symptoms, such as headaches, insomnia and fatigue may also accompany breathing problems.
Treatment of diaphragmatic paralysis is dependent on its symptoms, areas of involvement and underlying cause. In mild or moderate cases of unilateral diaphragmatic paralysis, a surgical procedure called plication may be attempted. Plication is a technique in which folds or pleats are sewn into the musculature. This aids in reducing the effort required for breathing.
If breathing is labored or severely impaired the use of a ventilator or breathing assistance machine may be necessary to assure there is an adequate amount of oxygen getting to the different body organs and systems. When serious breathing troubles are longstanding or occur with frequency a tracheostomy may be necessary. This is a procedure in which a hole is cut into the neck area so breathing can occur through the throat or windpipe.
Another surgical procedure used to treat bilateral diaphragmatic paralysis is diaphragmatic pacing. In this procedure, a device called a pacemaker is inserted into the chest. The pacemaker then stimulates the diaphragm muscles to contract by producing a small electric charge.
General health can become compromised with chronic diaphragmatic paralysis. It is important to treat the cause along with the breathing difficulties. This assures that the rest of the body is getting a sufficient amount of oxygen to function properly.
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