Diaphragmatic paralysis historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Historical Perspective

Discovery

Diaphragmatic paralysis first suggested as a therapeutic measure in lung disease by Steurtz (1911), who did simple phrenicotomy. Felix (1922) showed in 25% of cases this was ineffective owing to the presence of an accessory phrenic, and suggested phrenic exairesis, i.e. complete evulsion of the phrenic nerve. Goetze (1922) suggested radical phrenicotomy, i.e. division of the phrenic and excision of the nerve to the subclavius.Effects of diaphragmatic paralysis.-The diaphragm rises to the full expiratory position (4-8 cm.). Paradoxical movement (Kienböch's phenomenon) on affected side. Muscle atrophies. Collapse of the lung produced, affecting base and apex also. Lung volume reduced by (1/6)th to (1/3)rd.Physical signs.-Indrawing of the epigastrium. Thoracic breathing. Litten's sign absent. Less resistance to abdominal palpation on affected side. Diminished resonance at border of sternum and at base. Deficient inspiratory murmur at base.Radiography.-Paradoxical movement. Bittorf's test.

• Diaphragmatic paralysis was first suggested by Steurtz, in 1911 during simple phrenicotomy for treatment of lung disease.
• Thomas Harris, in 1892, stated that depression of the epigastric and hypochondriac regions on deep inspiration not always indicative of diaphragmatic paralysis.

• The association between [important risk factor/cause] and [disease name] was made in/during [year/event].
• In [year], [scientist] was the first to discover the association between [risk factor] and the development of [disease name].
• In [year], [gene] mutations were first implicated in the pathogenesis of [disease name].

Outbreaks

• There have been several outbreaks of [disease name], which are summarized below:

Landmark Events in the Development of Treatment Strategies

• In 1911,

• In [year], [diagnostic test/therapy] was developed by [scientist] to treat/diagnose [disease name].

Famous Cases

• The following are a few famous cases of disease name: