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Diaphragmatic flutter
  1. Dean Walton,
  2. Michael Bonello,
  3. Malcolm Steiger
  1. Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
  1. Correspondence to Dr Michael Bonello, Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool L9 7LJ, UK; michael.bonello{at}thewaltoncentre.nhs.uk

Abstract

A 78-year-old woman presented with involuntary movements of her abdomen, which started after a right hemispheric stroke. She had irregular, variable, hyperkinetic predominantly right-sided abdominal wall movements. MR scan of brain confirmed a recent infarct in the right occipitotemporal lobe and the right cerebellum. Diaphragmatic fluoroscopy confirmed high-frequency flutter as the cause of her abdominal movements and confirmed the diagnosis of van Leeuwenhoek’s disease. Anthonie van Leeuwenhoek first described this condition in 1723 and had the condition himself. He was a Dutch businessman who is often acknowledged as the first microscopist and microbiologist. He disagreed with his physician who attributed his ailment as being of cardiac origin. Diaphragmatic flutter is a rare disorder that requires a high index of suspicion with symptoms including abnormal abdominal wall movements, dyspnoea and respiratory distress. Despite medical treatment, the patient was still highly symptomatic, so she is currently being considered for a phrenic nerve crush.

  • movement disorders
  • diaphragmatic flutter
  • diaphragmatic myoclonus

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Footnotes

  • Contributors DW and MB were responsible for drafting the manuscript and subsequent revisions and are guarantors of the paper. MS provided critical revision for intellectual content.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Commissioned; externally peer reviewed. This paper was reviewed by Jeremy Stern, London, UK.

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