{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:51:02Z","timestamp":1790286662542,"version":"4.1.0"},"reference-count":5,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,6,19]]},"abstract":"<jats:p>A 45-year-old man with a raised body mass index presented with an acute history of right lower chest pain and increasing breathlessness. C reactive protein, D dimer and cardiac echocardiography were negative, with mild bibasal atelectasis the only positive reported finding from erect chest X-ray and CT pulmonary angiogram. He was discharged with antibiotics for a chest infection. He remained severely breathless and was referred to the sleep-related breathing disorders clinic. He described shoulder pain, daytime tiredness and sleeping upright due to a \u00c3\u00a2\u00e2\u201a\u00ac\u00cb\u0153suffocating\u00c3\u00a2\u00e2\u201a\u00ac\u00e2\u201e\u00a2 sensation. The video demonstrates the clinical findings. The CT topogram confirmed bilateral diaphragmatic paralysis. Spirometry demonstrated an 80% reduction in forced vital capacity in the supine position, when compared with erect. Consultation with a neurologist yielded the diagnosis of neuralgic amyotrophy, leading to bilateral diaphragmatic paralysis. The respiratory symptoms have been controlled with night-time non-invasive ventilation, allowing him to sleep supine.<\/jats:p>","DOI":"10.1136\/bcr-2017-219892","type":"journal-article","created":{"date-parts":[[2017,7,18]],"date-time":"2017-07-18T07:10:18Z","timestamp":1500361818000},"page":"bcr-2017-219892","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["A case of progressive orthopnoea and shoulder pain secondary to bilateral diaphragmatic paralysis"],"prefix":"10.1136","volume":"2017","author":[{"given":"Anna","family":"Herbert","sequence":"first","affiliation":[{"name":"Respiratory Medicine, Royal Albert Edward Infirmary, Wigan, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waseem Asrar","family":"Khan","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Royal Albert Edward Infirmary, Wigan, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salem","family":"Madi","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Royal Albert Edward Infirmary, Wigan, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,7,18]]},"reference":[{"key":"2025082802165907000_2017.jul18_1.bcr-2017-219892.1","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1007\/s00408-015-9716-8","article-title":"Severe Acute Orthopnea: Ipilimumab-Induced Bilateral Phrenic Nerve Neuropathy","volume":"193","author":"Jinnur","year":"2015","journal-title":"Lung"},{"key":"2025082802165907000_2017.jul18_1.bcr-2017-219892.2","first-page":"513","article-title":"[A case of bilateral diaphragmatic paralysis clinically suggestive of brachial neuritis]","volume":"43","author":"Kadowaki","year":"2005","journal-title":"Nihon Kokyuki Gakkai Zasshi"},{"key":"2025082802165907000_2017.jul18_1.bcr-2017-219892.3","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.48.1266"},{"key":"2025082802165907000_2017.jul18_1.bcr-2017-219892.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-5876(98)00172-4"},{"key":"2025082802165907000_2017.jul18_1.bcr-2017-219892.5","first-page":"139","article-title":"Neuralgic amyotrophy: a rare cause of bilateral diaphragmatic paralysis","volume":"5","author":"Shinder","year":"1998","journal-title":"Can Respir J"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-219892","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:17:10Z","timestamp":1756372630000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-219892"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7,18]]},"references-count":5,"alternative-id":["10.1136\/bcr-2017-219892"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-219892","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7,18]]}}}