PT  - JOURNAL ARTICLE
AU  - Dean Walton
AU  - Michael Bonello
AU  - Malcolm Steiger
TI  - Diaphragmatic flutter
AID  - 10.1136/practneurol-2017-001830
DP  - 2018 Feb 01
TA  - Practical Neurology
PG  - practneurol-2017-001830
4099  - http://pn.bmj.com/content/early/2018/01/31/practneurol-2017-001830.short
4100  - http://pn.bmj.com/content/early/2018/01/31/practneurol-2017-001830.full
AB  - 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.