Correct!
5. All of the above

Treatment options are limited for diaphragmatic paralysis (6). Supportive therapy including assisted ventilation may be used. Some surgeons report good results with diaphragm plication. This minimally invasive surgery involves repositioning and reshaping the paralyzed diaphragm by folding it over itself and suturing it into place, allowing the lungs to expand more effectively and improve breathing function in patients with diaphragm paralysis. Diaphragmatic pacing can also be used. Some surgeons report good results with either diaphragm plication or diaphragm pacing but case series are small and depend upon local surgical expertise. Our patient remained minimally symptomatic without therapy.

References

  1. Heffner JE. Diaphragmatic paralysis following chiropractic manipulation of the cervical spine. Arch Intern Med. 1985 Mar;145(3):562-4. [PubMed]
  2. Schram DJ, Vosik W, Cantral D. Diaphragmatic paralysis following cervical chiropractic manipulation: case report and review. Chest. 2001 Feb;119(2):638-40. [CrossRef] [PubMed]
  3. John S, Tavee J. Bilateral diaphragmatic paralysis due to cervical chiropractic manipulation. Neurologist. 2015 Feb;19(3):65-7. [CrossRef] [PubMed]
  4. Young R, Huthayfa A, Sam A. Medical image of the week: a positive sniff test. Southwest J Pulm Crit Care. 2017;14(5):199-200. [CrossRef]
  5. Nason LK, Walker CM, McNeeley MF, Burivong W, Fligner CL, Godwin JD. Imaging of the diaphragm: anatomy and function. Radiographics. 2012 Mar-Apr;32(2):E51-70. [CrossRef] [PubMed]
  6. O'Toole SM, Kramer J. Unilateral diaphragm paralysis. StatPearls. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available at: https://www.ncbi.nlm.nih.gov/books/NBK430685/?term=Unilateral%20Diaphragmatic%20Paralysis (accessed 7/17/24).

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