{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T00:28:18Z","timestamp":1774744098674,"version":"3.50.1"},"reference-count":8,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,1,1]]},"abstract":"<jats:p>Hemidiaphragmatic paralysis is usually caused by surgery, malignancy or trauma and rarely by viral infections. Herpes zoster (shingles) results in varied neurological complications, but peripheral motor involvement or diaphragmatic paralysis is rare. We report the case of an 87-year-old male who presented with worsening breathlessness soon after an episode of shingles, affecting his right neck and upper chest. He had no alarm symptoms, history of trauma or malignancy. Skin lesions resolved after a few weeks, but his breathing did not improve. Chest X-ray revealed a new finding of elevated right hemidiaphragm; diaphragmatic ultrasound confirmed paradoxical cranial movement of right hemidiaphragm on sniff testing. CT scan showed no lung mass and complete collapse of right lower lobe due to elevated right hemidiaphragm. Patient has required no treatment and is under regular follow-up with the ventilation clinic.<\/jats:p>","DOI":"10.1136\/bcr-2017-222229","type":"journal-article","created":{"date-parts":[[2018,1,23]],"date-time":"2018-01-23T23:30:20Z","timestamp":1516750220000},"page":"bcr-2017-222229","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Unusual case of hemidiaphragmatic paralysis secondary to cervical herpes zoster"],"prefix":"10.1136","volume":"2018","author":[{"given":"Muhammad Adnan","family":"Saleem","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, University Hospitals of North Midlands NHS Trust, Stoke on Trent, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeeshan","family":"Mustafa","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, University Hospitals of North Midlands NHS Trust, Stoke on Trent, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noman","family":"Qayyum","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Hospitals of North Midlands NHS Trust, Stoke on Trent, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Badar","family":"Ganaie","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, University Hospitals of North Midlands NHS Trust, Stoke on Trent, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,1,23]]},"reference":[{"key":"2025082800344274000_2018.jan23_1.bcr-2017-222229.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g2911"},{"key":"2025082800344274000_2018.jan23_1.bcr-2017-222229.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200003023420906"},{"key":"2025082800344274000_2018.jan23_1.bcr-2017-222229.3","first-page":"345","article-title":"[A case of diaphragmatic paralysis following herpes zoster]","volume":"36","author":"Fujimoto","year":"1996","journal-title":"Rinsho Shinkeigaku"},{"key":"2025082800344274000_2018.jan23_1.bcr-2017-222229.4","doi-asserted-by":"crossref","first-page":"149","DOI":"10.4103\/0970-2113.129846","article-title":"Bilateral diaphragmatic paralysis in an HIV patient: Second reported case and literature review","volume":"31","author":"Melero","year":"2014","journal-title":"Lung India"},{"key":"2025082800344274000_2018.jan23_1.bcr-2017-222229.5","first-page":"166","article-title":"[A case of diaphragmatic paralysis caused by herpes zoster after anticancer chemotherapy]","volume":"45","author":"Morinaga","year":"2007","journal-title":"Nihon Kokyuki Gakkai Zasshi"},{"key":"2025082800344274000_2018.jan23_1.bcr-2017-222229.6","first-page":"e07","article-title":"Hemi-diaphragmatic paralysis and herpes zoster infection in a renal transplant recipient; a case report","volume":"3","author":"Abideen","year":"2017","journal-title":"Immunopathol Persa"},{"key":"2025082800344274000_2018.jan23_1.bcr-2017-222229.7","first-page":"289","article-title":"Unilateral diaphragm paralysis: etiology, impact, and natural history","volume":"49","author":"Elefteriades","year":"2008","journal-title":"J Cardiovasc Surg"},{"key":"2025082800344274000_2018.jan23_1.bcr-2017-222229.8","doi-asserted-by":"crossref","first-page":"311","DOI":"10.2143\/ACB.3307","article-title":"Diaphragm plication for unilateral diaphragm paralysis: a case report and review of the literature","volume":"68","author":"Declerck","year":"2013","journal-title":"Acta Clin Belg"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-222229","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T07:34:49Z","timestamp":1756366489000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-222229"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,23]]},"references-count":8,"alternative-id":["10.1136\/bcr-2017-222229"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-222229","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,23]]}}}