Diaphragm flutter — also known as diaphragmatic flutter or diaphragmatic myoclonus — is a rare disorder in which your diaphragm experiences repeated involuntary contractions. The diaphragm is a muscle just below your lungs that separates your chest and upper abdomen.
It’s the primary muscle responsible for pushing air in and out of your lungs when you breathe. Because of the diaphragm’s importance for respiration, people with diaphragm flutter often have difficulty breathing.
The contractions caused by diaphragm flutter often look like movements made by a belly dancer. This is why the condition is commonly known as belly dancer’s dyskinesia (BDD). Dyskinesia simply refers to a body movement that you can’t control.
What Are the Symptoms of Diaphragm Flutter?
The main symptoms of diaphragm flutter vary in intensity from person to person, and they may not even show in mild cases. Symptoms may include:
- breathing difficulties
- chest pain
- heart palpitations
- abdominal pain
Diaphragm flutter causes repetitive, rhythmic, and noticeable movement in the upper abdomen. In some cases, the contractions may also move toward the surrounding muscles that are used for breathing.
The rapid, undulating movements are usually seen in the front of the body near the chest and not on the back. Diaphragm flutter is almost always bilateral — meaning it affects both the left and right sides of the body equally.
Episodes of chest muscle spasms can begin suddenly and last from a few minutes to a couple of hours. Longer bouts of repeated contractions can be extremely painful.
Diaphragm flutter can also cause a wide range of additional symptoms like:
- hyperventilation
- acid reflux
- dyspnea
- sleep disorders
- hiccups
The symptoms generally get worse during the day, and may be triggered by stress. They don’t usually show up during sleep.
What Are the Causes of Diaphragm Flutter?
The causes of diaphragm flutter are not well understood. Over the years, research has been conducted, but a cause hasn’t been found. The disorder is rare, and it often occurs with other serious diseases, including:
- encephalitis
- peritonitis
- stroke
- rheumatic fever
- tumors of the spine or chest
- pleurisy
- adenopathies
Some evidence has shown that damage to the nerves of the brain or spinal cord may be responsible for diaphragm flutter. It may also be caused by abdominal surgery. Some antipsychotic medications typically prescribed for psychiatric disorders may also trigger diaphragm flutter.
How Is Diaphragm Flutter Diagnosed?
Your doctor may diagnose the condition by looking at your diaphragm movements with ultrasound and fluoroscopy. Doctors are able to measure the diaphragm’s contractions in real time and determine their amplitude and rate.
Electromyography — or EMG — can help to confirm the diagnosis. EMG measures your muscle’s response to stimulation from a nerve. This helps doctors evaluate whether there’s an abnormality or malfunction in the movement of signals between your nerves and muscles.
Your doctor may also ask you to get an MRI of the brain and spinal cord to make sure you have no other neurological disorder.
How Is Diaphragm Flutter Treated?
Because diaphragm flutter is a very rare condition, there are no clear guidelines on which treatment plan is the best.
Sedatives or muscle relaxant medications are often the first treatments for diaphragm spasms.
They could include:
- diazepam (Valium)
- clonazepam (Klonopin)
- haloperidol (Haldol)
- aripiprazole
- diphenylhydantoin
Because the condition is rare, treatment is often done on a case-by-case basis.
Surgery that cuts off a part of the malfunctioning nerve may also be helpful to relieve symptoms, but only as a last resort treatment.