Unilateral Diaphragmatic Paralysis As The Initial Manifestation Of Motor Neuron Disease

Motor neuron disease (MND) (4) a group of disorders Where there is degeneration of both upper and lower Motor neurons. They are mainly classified in to Congenital and acquired. Here we are concerned with acquired motor neuron diseases. These are classified in to Progressive bulbar paralysis, progressive muscular atrophy, Amyotrophic lateral sclerosis and Primary lateral sclerosis. There are other Atypical variants such as Monomelic MND, Wasted leg syndrome, and Madras Motor neuron disease. Here we present a rare variant which has an initial manifestation of Unilateral diaphragmatic paralysis with exertional dyspnoea which further progressed to involve intercostal muscles and later upper limb muscles. This is one of the rare variants with such respiratory manifestation .. Hence we report this case as an atypical manifestation.