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[This article belongs to Volume - 25, Issue - 06]

Diaphragmatic flutter in Adolescent male - A rare case report.

Diaphragmatic flutter is an infrequent disorder characterized by high-frequency rhythmic involuntary contractions of the diaphragm and other respiratory muscles. In this communication, we are reporting a rare case of diaphragmatic flutter in 20-year-old male -thoracic, abdominal and para-spinal muscles showed a myoclonic pattern of involuntary contractions in thoracic level (T4 to T12). Since there was a suspicion of diaphragmatic flutter, we evaluated movements of diaphragm with fluoroscopy. It showed a repetitive rhythmic movements of the diaphragm (112 movements per minute) and normal diaphragm mobility with respiratory cycle both in inspiration and expiration. Thus the patient was diagnosed to have diaphragmatic flutter. He was advised on carbamazepine 400 mg thrice daily with other supportive measures. Patient was symptomatically improved and discharged Later we got the opinion of cardiothoracic surgeon who suggested VATS guided Clipping/Crushing of phrenic nerve at C4 level if there was poor clinical response /recurrence.