What is Phrenic Nerve and Where is it Located?
The Phrenic Nerve is an extremely important nerve in the body which controls the diaphragm and assists in an individual breathing on his or her own accord. This nerve is actually divided into two parts although it begins as a single nerve from the neck. The Phrenic Nerve also allows an individual to hold his or her breath and also facilitates taking a deep breath whenever required.
This ability of an individual to control his or her breath is lost in cases of a Phrenic Nerve Damage, as the phrenic nerve is no longer able to send signals to the brain to control the diaphragm. This nerve begins in the brain and traverses down through the cervical spine where it then gets divided into two parts. These two nerves now traverse down each side of the body and courses in close proximity of the heart and lungs and meet at the diaphragm.
Since these nerves are in close proximity to the heart and lungs thus any problems in these two organs of the body can impact the functioning of the Phrenic Nerve. A Phrenic Nerve Damage results in interruption of signals between the phrenic nerve and the brain and thus the functioning of the diaphragm is affected causing an individual to have problems with breathing due to Phrenic Nerve Damage.
What Causes Phrenic Nerve Damage?
Any damage to the phrenic nerve results in the nerve being not able to function normally. Phrenic Nerve Damage can happen due to a variety of reasons. There are some medical conditions that affect the functioning of the Phrenic Nerve directly, although it is more common for an individual to have a condition in which the nerves are affected including the phrenic nerve. Phrenic Nerve Damage can result in an individual having difficulty breathing. Some of the common cases of Phrenic Nerve Damage are:
- Spinal Cord Injury. An injury to the spinal cord especially if the injury is to the upper cervical spine then it may result in Phrenic Nerve Damage.
- Physical trauma like a motor vehicle crash affecting the abdominal or chest area or a physical assault may cause Phrenic Nerve Damage
- Neck injury as a result of a motor vehicle crash or an assault may cause Phrenic Nerve Damage
- Phrenic Nerve Damage can also be caused due to trauma caused during a surgical procedure. This is most common in cardiac surgery or abdominal surgeries.
What are the Symptoms of Phrenic Nerve Damage?
The symptoms of Phrenic Nerve Damage are variable and depend on whether only one nerve is damaged or both the nerves are damaged. In cases of only one Phrenic Nerve being damaged then the individual may continue to breathe and should have no problems. In case if both the nerves are damaged then it tends to cause severe difficulty breathing as the diaphragm ceases to function. Thus it becomes an emergent situation where breathing needs to be restored as quickly as possible before the individual goes into respiratory failure which can be life threatening. Some of the other symptoms of Phrenic Nerve Damage are:
- Difficulty with Hiccups. This is a common symptom as an irritated phrenic nerve can cause the hiccup reflex to get activated and make the diaphragm contract abnormally.
- Diaphragm paralysis is the most severe symptom of Phrenic Nerve Damage as in such cases the breathing becomes extremely labored for the patient and artificial respiration is required.
How is Phrenic Nerve Damage Treated?
Since restoring normal breathing is the need of the hour when treating Phrenic Nerve Damage, the treatment is aimed at restoring normal breathing pattern. This is usually done with a breathing pacemaker.
A breathing pacemaker is a device which takes over control of the diaphragm from the damaged phrenic nerve. The electrodes of the pacemaker are implanted around the phrenic nerve and the device causes the electrodes to get activated and contracts the diaphragm allowing breathing to take place.
The breathing pacemaker also provides ventilatory support to individuals with Phrenic Nerve Damage who have underlying conditions like ALS or a spinal cord injury. People with stroke and central nervous system disorders are also benefitted by breathing pacemaker as they allow them to get rid of the mechanical ventilator which carries with it increased risk of infections which may complicate the picture.
What is the Prognosis of Phrenic Nerve Damage?
The prognosis for Phrenic Nerve Damage is good for individuals who have only one nerve that is damaged. Such individuals do not require any aggressive treatments. However, individuals who have bilateral Phrenic Nerve Damage require breathing support with the help of breathing pacemakers and at times ventilatory support so as to normalize breathing to some extent and prevent any serious complications from Phrenic Nerve Damage.