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July 11, 1977

Diaphragmatic Paralysis

JAMA. 1977;238(2):128. doi:10.1001/jama.1977.03280020032012

To the Editor.—  The recent article, "Transient Paralysis of the Phrenic Nerve Associated With Head Injury" by Prasad and Athreya (236:2532, 1976) contains an error in referencing. The authors quote Keltz et al1 as demonstrating reduced movements of the diaphragm on the side of hemiplegia in patients with stroke. In fact (and as can be seen from the title of the article by Keltz et al), these authors made no observation on hemiplegic patients. Prasad and Athreya may have intended to refer to another paper2 in which we demonstrated reduced excursions of the hemidiaphragm on the paralyzed side in stroke patients. In another paper3 we correlated the position of the two hemidiaphragmatic leaves in routine chest x-ray films of stroke patients and compared the results with a control group. Elevation of the left hemidiaphragm was common in patients with left hemiparesis or hemiplegia, while right hemidiaphragm elevation