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A patient with dyspnoea was found to have a complete diaphragmatic paralysis due to a bilateral phrenic nerve lesion, without evidence of a generalized neuromuscular disease. The functional sequelae of breathing with intercostal and auxiliary inspiratory muscles were studied in the patient both while awake and asleep. This we believe is the second case of idiopathic bilateral paralysis of the diaphragm described in the literature.
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