Phrenic neuropathy and diaphragm dysfunction in neuralgic amyotrophy

Nens Van Alfen, Jonne Doorduin, Marieke H.J. Van Rosmalen, Jeroen J.J. Van Eijk, Yvonne Heijdra, Andrea Boon, Michael A. Gaytant, Ries J.M. Van Den Biggelaar, Roy T.M. Sprooten, Peter J. Wijkstra, Jan T. Groothuis

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective To describe the clinical phenotype and recovery of diaphragm dysfunction caused by neuralgic amyotrophy in a large cohort of patients, to improve accurate awareness of this entity, and to encourage adoption of a standardized approach for diagnosis and treatment. Methods This observational cohort study recruited adult patients with neuralgic amyotrophy and symptoms of idiopathic phrenic neuropathy from the database of the Dutch expert center for neuralgic amyotrophy and the Dutch centers for home mechanical ventilation. Demographic and clinical information on diagnosis, symptoms, and recovery was obtained from chart review. We attempted to contact all patients for a follow-up interview. Results Phrenic neuropathy occurs in 7.6% of patients with neuralgic amyotrophy. Unilateral diaphragmatic dysfunction and bilateral diaphragmatic dysfunction are frequently symptomatic, causing exertional dyspnea, orthopnea, disturbed sleep, and excessive fatigue. Diagnostic practices varied widely and were often not optimally targeted. The majority of patients experienced at least moderate recovery within 2 years. Conclusion We recommend screening every patient with neuralgic amyotrophy for diaphragm dysfunction by asking about orthopnea and by performing upright and supine vital capacity screening and diaphragm ultrasound in cases of suspected phrenic neuropathy to optimize diagnosis and care.

Original languageEnglish (US)
Pages (from-to)e843-e849
JournalNeurology
Volume91
Issue number9
DOIs
StatePublished - Aug 28 2018

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Brachial Plexus Neuritis
Diaphragm
Vital Capacity
Artificial Respiration
Dyspnea
Observational Studies
Fatigue
Sleep
Cohort Studies
Demography
Databases
Interviews
Phenotype

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Van Alfen, N., Doorduin, J., Van Rosmalen, M. H. J., Van Eijk, J. J. J., Heijdra, Y., Boon, A., ... Groothuis, J. T. (2018). Phrenic neuropathy and diaphragm dysfunction in neuralgic amyotrophy. Neurology, 91(9), e843-e849. https://doi.org/10.1212/WNL.0000000000006076

Phrenic neuropathy and diaphragm dysfunction in neuralgic amyotrophy. / Van Alfen, Nens; Doorduin, Jonne; Van Rosmalen, Marieke H.J.; Van Eijk, Jeroen J.J.; Heijdra, Yvonne; Boon, Andrea; Gaytant, Michael A.; Van Den Biggelaar, Ries J.M.; Sprooten, Roy T.M.; Wijkstra, Peter J.; Groothuis, Jan T.

In: Neurology, Vol. 91, No. 9, 28.08.2018, p. e843-e849.

Research output: Contribution to journalArticle

Van Alfen, N, Doorduin, J, Van Rosmalen, MHJ, Van Eijk, JJJ, Heijdra, Y, Boon, A, Gaytant, MA, Van Den Biggelaar, RJM, Sprooten, RTM, Wijkstra, PJ & Groothuis, JT 2018, 'Phrenic neuropathy and diaphragm dysfunction in neuralgic amyotrophy', Neurology, vol. 91, no. 9, pp. e843-e849. https://doi.org/10.1212/WNL.0000000000006076
Van Alfen N, Doorduin J, Van Rosmalen MHJ, Van Eijk JJJ, Heijdra Y, Boon A et al. Phrenic neuropathy and diaphragm dysfunction in neuralgic amyotrophy. Neurology. 2018 Aug 28;91(9):e843-e849. https://doi.org/10.1212/WNL.0000000000006076
Van Alfen, Nens ; Doorduin, Jonne ; Van Rosmalen, Marieke H.J. ; Van Eijk, Jeroen J.J. ; Heijdra, Yvonne ; Boon, Andrea ; Gaytant, Michael A. ; Van Den Biggelaar, Ries J.M. ; Sprooten, Roy T.M. ; Wijkstra, Peter J. ; Groothuis, Jan T. / Phrenic neuropathy and diaphragm dysfunction in neuralgic amyotrophy. In: Neurology. 2018 ; Vol. 91, No. 9. pp. e843-e849.
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