caa a22 4500 445356308 CHVBK 20180317142901.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1007/s10072-011-0501-z doi (NATIONALLICENCE)springer-10.1007/s10072-011-0501-z Contralateral diaphragmatic palsy after subcortical middle cerebral artery infarction without capsular involvement [Elektronische Daten] [Meng-Ni Wu, Po-Nien Chen, Chiou-Lian Lai, Li-Min Liou] Diaphragmatic palsy after acute stroke is a novel clinical entity and may result in a high incidence of respiratory dysfunction and pneumonia, which especially cause greater morbidity and mortality. Generally, internal capsule and complete middle cerebral artery (MCA) infarctions are major risk-factors for developing diaphragmatic palsy. Herein, we present a case with contralateral diaphragmatic palsy after a subcortical MCA infarction without capsular involvement. Dyspnea occurred after stroke, while a chest X-ray and CT study disclosed an elevated right hemidiaphragm without significant infiltration or patch of pneumonia. A phrenic nerve conduction study showed bilateral mild prolonged onset-latency without any significant right-left difference. This suggested a lesion causing diaphragmatic palsy was not in the phrenic nerve itself, but could possibly originate from an above central location (subcortical MCA infarction). We also discussed the role of transcranial magnetic stimulation study in the survey of central pathway and demonstrated diaphragmatic palsy-related orthopnea. Springer-Verlag, 2011 Diaphragmatic palsy nationallicence Cortico-diaphragmatic pathway nationallicence Acute ischemic nationallicence Stroke nationallicence Orthopnea nationallicence Wu Meng-Ni Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC aut Chen Po-Nien Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC aut Lai Chiou-Lian Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC aut Liou Li-Min Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC aut Neurological Sciences Springer Milan 32/3(2011-06-01), 487-490 1590-1874 32:3<487 2011 32 10072 https://doi.org/10.1007/s10072-011-0501-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10072-011-0501-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Wu Meng-Ni Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC aut NATIONALLICENCE 700 1- Chen Po-Nien Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC aut NATIONALLICENCE 700 1- Lai Chiou-Lian Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC aut NATIONALLICENCE 700 1- Liou Li-Min Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC aut NATIONALLICENCE 773 0- Neurological Sciences Springer Milan 32/3(2011-06-01), 487-490 1590-1874 32:3<487 2011 32 10072 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer