All are true about bilateral diaphragmatic paralysis, Except:
Correct Answer: Causes normocapnic failure
Description: Ans. is 'b' causes normocapnic failure (Ref. Harrison, 17/e, p 221, 1663 & 16/e, p 1572, 72 (15/e, p. 1516)).Most patients with bilateral diaphragmatic paralysis presents with hypercapnic failure.There is confusion with sniff test (option A).Sniff test: It is used in the diagnosis of unilateral diaphragmatic paralysis."A patient is observed with fluoroscopy while sniffing, the paralyzed diaphragm will move paradoxically upwardWhether it is used in the diagnosis of bilateral diaphragmatic paralysis is not confirmed.The treatment of choice for bilateral diaphragmatic palsy is assisted ventilation for all or part of each day. If the nerve to diaphragm is intact diaphragmatic pacing may be viable alternative.Some other important points;Patients with unilateral diaphragmatic palsy are usually asymptomatic*. Most common cause of unilateral nerve palsy is - nerve invasion from bronchogenic carcinoma.Common causes of bilateral diaphragmatic palsy includesHigh spinal cord injuryThoracic traumaSpinal cord injuryAnterior horn disease
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