Sir.—With reference to the interesting report on paralysis of the diaphragm by Greene et al in the December issue of the Journal (129:1402-1405, 1975), may I note that there has been described1 a simple physical sign that might expedite the diagnosis in cases of complete unilateral diaphragmatic paralysis, the usual situation encountered, before intermittent positive pressure breathing is instituted. It consists of a respiratory shift visualized on the epigastric abdominal wall, which reflects the paradoxical movement of the diaphragm within. This is seen in infants and young children but not in adults, and may not be present in older children.
LIGHT JS. Paralysis of the Diaphragm. Am J Dis Child. 1976;130(5):565–566. doi:10.1001/archpedi.1976.02120060111021