No abstract available.
Herpes Zoster* ; Respiratory Paralysis*

Wegener's granulomatosis (WG) is defined as a granulomatous inflammation of the upper and lower respiratory tract due to a systemic vasculitis. Facial nerve palsy may occur during the course of any granulomatous or vasculitis disease. But very few cases have been reported in which facial nerve palsy is the presenting feature of WG. We recently experienced an interesting case of WG presenting as acute middle ear infection and subsequent bilateral facial palsy.
Ear, Middle ; Earache ; Facial Nerve ; Facial Paralysis ; Inflammation ; Paralysis ; Respiratory System ; Systemic Vasculitis ; Vasculitis ; Wegener Granulomatosis

The motor complications after herpes zoster infection are uncommon, but, the association of muscular paralysis and zoster has been reported for several times. The association between diaphragmatic paralysis and zoster was for the first time reported by Halpern and Covner. The case presented below showed right diaphragmatic paralysis following herpes zoster of C3 and C4 region of dermatome on the right side. A 59-year-old man was found to have a paralysed hemidiaphragm within two months of the appearance of typical herpes zoster rashs involving his right shoulder and neck. Investigations, including bronchoscopy, failed to detect other cause for the diaphragmatic paralysis. We believe that the cervical zoster and diaphragmatic paralysis were causally related.
Bronchoscopy ; Exanthema ; Herpes Zoster* ; Humans ; Middle Aged ; Neck ; Paralysis ; Respiratory Paralysis* ; Shoulder

Diaphragmatic eventration is a rare disease and is caused by congenital etiology. We operated on a patient who had had preexisting left diaphragmatic eventration which was complicated by a right diaphragmatic paralysis and a persistent respiratory insufficiency due to a traffic accident. This was a very rare case and there has not yet been any case reports worldwide. We were able to abtain good surgical results from plication of left diaphragm in this case and thus report it.
Accidents, Traffic ; Diaphragm ; Diaphragmatic Eventration* ; Humans ; Rare Diseases ; Respiratory Insufficiency ; Respiratory Paralysis*

Sjogren syndrome is a chronic autoimmune disease characterized by lymphocytic infiltration of exocrine glands resulting in dry mouth and eyes. Approximately one-third of patients present with systemic manifestations, but respiratory muscle involvements have been rarely reported. We report a case of acute respiratory failure complicated by primary Sjogren syndrome. Muscle biopsy revealed perivascular lymphocytic infiltrations. Corticosteroid therapy improved respiratory muscle weakness. Sjogren syndrome should be considered as one of the underlying diseases causing acute respiratory failure.
Autoimmune Diseases ; Biopsy ; Exocrine Glands ; Humans ; Mouth ; Muscular Diseases ; Respiratory Insufficiency ; Respiratory Muscles* ; Respiratory Paralysis ; Sjogren's Syndrome*

Herpes zoster is a varicella-zoster virus reactivation that is characterized by pain and rash. It can cause motor paresis on affecting muscles, but diaphragmatic paralysis is a rare complication. Methods of evaluation of diaphragmatic paralysis include plain radiography, fluoroscopy and electroneurography. The direct movement of diaphragmatic muscles on ultrasound can also be used to diagnose diaphragmatic paralysis. We reported a case of a 72-year-old woman who developed left hemidiaphragmatic paralysis after herpes zoster. The diaphragmatic paralysis occurred 3 weeks after appearance of a typical skin rash on the left C4-5 dermatomes. We diagnosed diaphragmatic paralysis using ultrasound.
Aged ; Diagnosis* ; Diaphragm ; Exanthema ; Female ; Fluoroscopy ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Muscles ; Paralysis ; Paresis ; Radiography ; Respiratory Paralysis* ; Ultrasonography*

Neonatal vocal cord paralysis is the second most common laryngeal anomaly, which accounts for approximately 10% of all congenital laryngeal lesions. Neonate with bilateral vocal cord paralysis are charactenzed with a glottic obstruction which usually shows dyspnea and inspiratory stridor. Treatment of bilateral vocal cord paralysis in neonate have two major goals : restore proper breathing and retain the voice. Tracheostomy is the best method for restoring breating in neonate. The prognosis of bilateral paralysis looks worse. Spontaneous recovery was seen in only half of the cases which usually occur in the idiopathic group and neurologic group. We experienced a case of bilateral vocal cord paralysis in a neonate who showed dyspnea, cyanosis and inspiratory stridor soon after birth. Diagnosis was confirmed by direct laryngoscopy and he was treated with tracheostomy.
Cyanosis ; Diagnosis ; Dyspnea ; Humans ; Infant, Newborn* ; Laryngoscopy ; Paralysis ; Parturition ; Prognosis ; Respiration ; Respiratory Sounds ; Tracheostomy ; Vocal Cord Paralysis* ; Vocal Cords* ; Voice

The occurrence of bilateral phrenic nerve injury in infants and children, usually associated with birth trauma or cardiotnoracic surgery can present difficulty in bedside recognition. The resultant bilateral diaphragmatic pareais or paralysis usually presenting as respiratory distress of difficulty in weaning from a ventilator can aignificantly prolong and complicate the hospital course. We experienced the bilateral diaphragmatic paralysis which developed after explothora-cotomy for removal of cystic hygroma in 10-month-old-age Patient. We recognized the diaphragmatic paralysis on 0ctober 16,1986 (postoperative 14 day) via fluoroscope and tracheoastomy was performed on postoperative 23 day. Electroconduction study was done twice on postoperative 19 and 40 day, in which at first neuropraxia ant later viability of phrenic nerve was revealed. The patient's spontaneous respiration was improved on postoperative 51 day and the SIMV (synchronized intermittent mandatory ventilation) and CPAP (continuous positive airway pressure) was applied, The patient was weaned from ventilator at postoperative 61 day and transferred with better condition after ICU 88 day to general ward.
Ants ; Child ; Humans ; Infant ; Lymphangioma, Cystic* ; Paralysis ; Parturition ; Patients' Rooms ; Phrenic Nerve ; Respiration ; Respiratory Paralysis* ; Ventilators, Mechanical ; Weaning

The diaphragm is especially important in sustaining minute ventilation in the neonate. Consequently, diaphragmatic paralysis is not tolerated well by the neonate and often results in prolonged respiratory failure. We experienced a case of unilateral diaphragmatic paralysis with the brachial plexus palsy in a male newborn infant who presented with apnea and cyanosis due to birth asphyxia. After endotracheal intubation, mechanical ventilaton was started. At two weeks after therapy, chest X-ray showed atelectasis and elevation of the right hemidiaphragm. The diagnosis of unilateral diaphragmatic paralysis was confirmed by real-time ultrasonography. At 4 weeks old, after several unsuccessful attempts at weaning from ventilatory support, right hemidiaphragm was plicated. On the second postoperative day, he could be weaned from ventiatory support without difficulty. He was doing well at follow-up 3 months later.
Apnea ; Asphyxia ; Brachial Plexus* ; Cyanosis ; Diagnosis ; Diaphragm ; Follow-Up Studies ; Humans ; Infant, Newborn* ; Intubation, Intratracheal ; Male ; Paralysis* ; Parturition ; Pulmonary Atelectasis ; Respiratory Insufficiency ; Respiratory Paralysis* ; Thorax ; Ultrasonography ; Ventilation ; Weaning

OBJECTIVE: To investigate the change of respiratory function and relationship between pulmonary function and functional improvement following rehabilitation in acute hemiplegic stroke patients. METHOD: Thirteen stroke patients were enrolled in this study. To evaluate hemi-diaphragmatic paralysis, we checked chest radiographs in the inspiration and expiration position of all patients. When diaphragmatic paralysis was suspected, fluoroscopy of diaphragm was conducted. To evaluate respiratory function, pulmonary function test and peak cough flow (PCF) were performed before and 3 weeks after conventional rehabilitation period. To evaluate correlation of functional performance, motor and pulmonary function, Motricity index and modified Barthel index were checked also before and 3 weeks after the period. RESULTS: Only one of 13 acute stroke patients was diagnosed as diaphragmatic paralysis. At initial evaluation of pulmonary function test, restrictive pattern was observed in 5 of 13 patients and female and patients with restrictive pattern generally showed lower pulmonary function scores. After rehabilitation, forced inspiratory vital capacity (FIVC), peak expiratory flow rate (PEF), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP) and PCF were significantly improved. Improvements of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1), MIP and FIVC were correlated with those of MBI. CONCLUSION: Decline in respiratory function could be occurred in acute hemiplegic stroke patients. Also, respiratory function could be improved with conventional rehabilitation and may be correlated with functional improvement. Therefore, the evaluation of respiratory function and active rehabilitation therapy should be conducted in acute stage to prevent pulmonary complications and promote functional recovery.
Cough ; Diaphragm ; Female ; Fluoroscopy ; Forced Expiratory Volume ; Hemiplegia ; Humans ; Paralysis ; Peak Expiratory Flow Rate ; Respiratory Function Tests ; Respiratory Paralysis ; Stroke ; Thorax ; Vital Capacity