Document Detail

Impairment of central motor conduction to the diaphragm in stroke.
MedLine Citation:
PMID:  8756819     Owner:  NLM     Status:  MEDLINE    
Respiratory complications are common in patients with stroke, but the involvement of the diaphragm in this setting is not completely understood. The purpose of this study was to assess corticodiaphragmatic pathways in patients with vascular hemiplegia. Fifteen patients were studied, nine with a capsular type of hemiplegia. Seven age-matched subjects served as the control group, and eight healthy young volunteers were studied to validate the methods by comparison with the literature. Diaphragm electromyogram was recorded bilaterally, using surface electrodes. Abductor pollicis brevis electromyogram was also recorded. After having checked the integrity of peripheral conduction, corticofugal pathways were studied using cortical magnetic stimulation, a reproducible and patient-independent stimulus. Left and right conduction times to the diaphragm were symmetrical in the control subjects, the young volunteers, and the six patients with hemiplegia but without capsular lesion (16.5 to 20.1 ms). Conversely, they were markedly asymmetrical in patients with capsular hemiplegia, diaphragm response on the plegic side being abolished or markedly delayed. Although the clinical impact of these findings remains to be determined, this study confirms that "central diaphragm paralysis" can be present in stroke. It also indicates that there is no bilateral motor representation of each hemidiaphragm.
T Similowski; M Catala; G Rancurel; J P Derenne
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  154     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  1996 Aug 
Date Detail:
Created Date:  1996-10-24     Completed Date:  1996-10-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  436-41     Citation Subset:  AIM; IM    
Service de Pneumologie et de Réanimation, Groupe Hospitalier Pitié-Salpĕtrière, Paris, France.
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MeSH Terms
Case-Control Studies
Cerebrovascular Disorders / complications*,  physiopathology
Diaphragm / innervation*,  physiopathology
Evoked Potentials / physiology
Hemiplegia / complications,  physiopathology
Median Nerve / physiopathology
Middle Aged
Motor Cortex / physiopathology*
Muscle, Skeletal / innervation,  physiopathology
Neural Conduction / physiology
Phrenic Nerve / physiopathology
Physical Stimulation
Prospective Studies
Respiratory Paralysis / etiology*,  physiopathology
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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