[Hemidiaphragmatic paralysis as a manifestation of familial brachial plexus neuropathy]. / Parálisis hemidiafragmática como manifestación de la plexopatía braquial familiar.

We present a patient with familial brachial plexus neuropathy (FBPN) who is in the second generation of a family found to have this disease. The patient suffered phrenic paralysis, which has only been previously described in association with FBPN in 4 similar cases, all of which also involved the left phrenic nerve. The side of phrenic paralysis's was unrelated to the side where brachial plexus lesions occurred. We believe that paralysis of the diaphragm, although rare, can be considered a sign of FBPN and that therefore this disease should be included in the differential diagnosis of such paralysis. This is particularly so whenever family or personal history suggest that the peripheral nervous system may be involved, compromising the brachial plexus, or whenever facial or digital dysmorphia is present.

[Complete third nerve paralysis as clinical presentation of multiple sclerosis]. / Parálisis completa del tercer par como forma de presentación de esclerosis múltiple.

An acute attack of cephalea and third nerve palsy with pupillary involvement may be caused by a variety of entities, but aneurysm of the posterior communicating artery must certainly be ruled out. We describe a 22 year old patient in whom this clinical profile was an unusual first sign of multiple sclerosis.