What are the common causes of diaphragmatic paralysis?

Diaphragmatic paralysis is caused by damage to the phrenic nerve, which blocks nerve impulses and causes paralysis and movement disorders on one or both sides of the diaphragm. So what are the causes of diaphragmatic paralysis?

1. Invasion or compression by malignant tumor

It is the most common clinically, and is often seen in mediastinal lymph node metastasis of lung cancer or direct invasion of central lung cancer and mediastinal tumors. It is also occasionally seen in malignant tumors of the pericardium, heart and pleura.

2. Traumatic phrenic nerve paralysis

Surgeries involving the mediastinum, including mediastinal tumors, lung cancer, pericardiectomy, coronary artery bypass grafting, open heart surgery, etc., may damage or even cut off the phrenic nerve. Various types of chest injuries and excessive traction on the baby's neck during delivery may also damage the phrenic nerve.

3. Cervical spine disease

Due to trauma, tumors, cervical bone hyperplasia or intervertebral disc disease and cervical tuberculosis, the phrenic nerve is compressed or damaged at the level of cervical vertebrae 3 to 5.

4. Neurological diseases

Brainstem diseases involving the respiratory center that innervates the phrenic nerve, infectious polyradiculitis, etc., may occasionally cause phrenic nerve paralysis.

5. Infectious diseases

Diseases such as polio, herpes zoster, and diphtheria can affect the phrenic nerve and cause paralysis.

6. Inflammatory diseases involving the mediastinum

Giant mediastinal lymphadenopathy, mediastinitis, etc. can damage the phrenic nerve, but this is very rare clinically.

7. Thoracic Surgery

It occasionally occurs when a nerve is accidentally damaged during chest surgery.

8. Others

Motor nerve unit disease, tuberculosis, pericarditis, mediastinitis, pneumonia, lead poisoning, etc. For example, a giant aortic aneurysm may cause left phrenic nerve paralysis. In some patients, no clear cause of phrenic nerve paralysis can be found.