Brachial plexopathy
A 50-year-old male presented with a complaint of acute-onset breathlessness in a lying position since the past 1 week, which was preceded by a herpes zoster infection causing facial palsy. The patient did not have any weakness in any of the limbs. On examination, he had paradoxical breathing, which was confirmed on fluoroscopy. The patient's routine blood investigations were within normal limits. Conventional nerve conduction studies were within normal limits. Phrenic nerve stimulation showed no response bilaterally that was suggestive of diaphragmatic failure. Considering it to be a presentation of brachial neuritis spectrum disorder, the patient was put on a trial of steroids. On follow-up at 2 months, he showed significant improvement in the symptoms of orthopnea.[]\nUnilateral or bilateral phrenic nerve involvement in neuralgic amyotrophy has been described, but isolated phrenic nerve involvement in brachial neuritis is unusual.