Breathing Issues and Phrenic Nerve Pacemakers
Question: I spoke with a neurologist who indicated that there is a surgical procedure that implants a phrenic nerve stimulator to drive the diaphragm muscle. Do you have any observations to make about such a device?
Dr. Bruno’s Response: Phrenic nerve pacemakers to activate the diaphragm are used in those whose phrenic nerves have been disconnected from the brain neurons that drive them but are still functioning and able to be stimulated (for example in quadriplegics, like Christopher Reeve).
A 1994 review in the journal Sleep (17(2):176-187) concluded, "patients who received diaphragmatic pacing and failed to benefit significantly include those with polio-induced damage to the phrenic nerve."
Noninvasive ventilation (BiPap, APAP and volume ventilators) seem to be the best treatment in polio survivors with breathing issues.