Disturbance of respiratory muscle control in a patient with early-stage multiple sclerosis.

Respiratory dysfunction from multiple sclerosis (MS) is most commonly of insidious onset and related to progressive respiratory muscle weakness [1]. Disorders of respiratory muscle coordination are poorly recognised and challenging to diagnose. We present a case of a patient with MS and no clear muscle weakness whose dyspnoea was associated with a disorder of respiratory muscle control. The potential utility of oesophageal manometry for diagnosis of unexplained dyspnoea is highlighted.