La par??lisis diafragm??tica bilateral es infrecuente y puede ser idiop??tica o m??s com?onmente asociada a varias entidades. Describimos el caso de un var?3n de 61 a?±os con antecedentes de asma bronquial quien desarroll?3 par??lisis difragm??tica bilateral sin causa evidente, la cual es excepcional. El paciente present?3 disnea progresiva y ortopnea, que no mejoraban con antibioterapia ni esteroides sist??micos, por lo que se descartaron diversas etiolog?-as como neuralgia lateral amiotr?3fica y finalmente se le diagnostic?3 par??lisis diafragm??tica lateral en base a la exploraci?3n f?-sica y las pruebas de imagen. Se inici?3 ventilaci?3n mec??nica no invasiva con gran mejor?-a cl?-nica. Abstract Bilateral paralysis of the diaphragm is uncommon and can be either idiopathic or more frequently associated with several medical conditions. We describe the case of a 61-year-old man with a history of asthma who developed severe bilateral diaphragmatic paralysis without any obvius cause, which is exceptional. The patient manifested progressive dyspnea and debilitating orthopnea with no improvement with antibiotics or systemic steroids. Different etiologies were discarded as amyotrophic lateral neuralgia, and he was diagnosed of bilateral diaphragmatic paralysis based on physical examination and imaging tests. Noninvasive mechanical ventilation was started with great clinical improvement. ?? DOI: http://dx.doi.org/10.21615/cesmedicina.30.1.9
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