Treatment for diaphragm paralysis begins with a comprehensive assessment of the patient's general health, how much shortness of breath affects their quality of life, and any underlying causes of the paralysis. If a primary cause leading to the paralysis is identified, treatment primarily focuses on eliminating this cause. For unilateral diaphragm paralysis, diaphragmatic plication (surgical tightening of the diaphragm dome) may be applied. In cases of bilateral diaphragm paralysis, if phrenic nerve EMG results indicate that the nerves are intact, diaphragm pacing therapy may be considered. In this method, typically two electrodes are placed on each diaphragm. These electrodes are routed out from the abdominal region and connected to a stimulator device. The device sends electrical impulses to the diaphragm muscles at set intervals, causing them to contract and thereby mechanically participate in respiration. For patients who do not achieve sufficient respiratory support despite all surgical interventions, mechanical ventilator support may be necessary to sustain respiration.