laryngismus

Laryngospasm
Classification and external resources
Specialty	pulmonology
ICD-10	J38.5
ICD-9-CM	478.75
MeSH	D007826
	[edit on Wikidata]

喉頭痙攣

関: laryngospasm

WordNet

laryngeal spasm caused by the sudden contraction of laryngeal muscles
a closure of the larynx that blocks the passage of air to the lungs

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/09/06 10:30:33」(JST)

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In medicine, laryngospasm is an uncontrolled/involuntary muscular contraction (spasm) of the vocal folds. The condition typically lasts less than 60 seconds, but in some cases can last 20-30 minutes and causes a partial blocking of breathing in, while breathing out remains easier. It may be triggered when the vocal cords or the area of the trachea below the vocal folds detects the entry of water, mucus, blood, or other substance. It is characterized by stridor and/or retractions. Some people suffer from frequent laryngospasms, whether awake or asleep. In an ear, nose and throat practice, it is typically seen in people who have silent reflux disease. It is also a well known, infrequent, but serious perioperative complication.

Etiology

In some individuals this can occur spontaneously or as a result of reflux or impaired swallowing. GERD is a common cause of spontaneous laryngospasm. Treating GERD can lessen the frequency of spasms. The onset of spasms may be caused by a viral infection.

It is also a complication associated with anesthesia. The spasm can happen often without any provocation, but tends to occur after tracheal extubation. In children, the condition can be particularly deadly, leading to cardiac arrest within 30–45 seconds, and is a possible cause of death associated with the induction of general anesthesia in the pediatric population. It can sometimes occur during sleep, waking up the patient. This usually occurs when the patient has gastric acidity and develops re-flux during sleep, where the gastric acid causes irritation which will cause the spasm attack.

Treatment

Minor laryngospasm will generally resolve spontaneously in the majority of cases.

Laryngospasm in the operating room is treated by hyperextending the patient's neck and administering assisted ventilation with 100% oxygen. In more severe cases it may require the administration of an intravenous muscle relaxant, such as Succinylcholine, and reintubation.

In ear, nose and throat practices, it is treated by examining the patient in the office and reassuring the patient that laryngospasm resolves. Sometimes reflux medication is used to reduce the acidity in the stomach.

Spontaneous laryngospasm can be treated by staying calm and breathing slowly, instead of gasping for air. Drinking (tiny sips) of ice water to wash away any irritants that may be the cause of the spasm can also help greatly.

Patients who are prone to laryngospasm during illness can take measures to prevent irritation such as antacids to avoid acid reflux, and constantly drinking water or tea keep the area clear of irritants.

Additionally, laryngospasms can result from hypocalcemia, causing muscle spasms and/or tetany. Na+ channels remain open even if there is very little increase in the membrane potential. This affects the small muscles of the vocal folds.

Prevention

When laryngospasm is coincident with a cold or flu, it may be helpful for some sufferers to take acid reflux medication to limit the irritants in the area. If a cough is present, then treat a wet cough; but limit coughing whenever possible, as it is only likely to trigger a spasm. Drink water or tea to keep the area from drying up. Saline drops also help to keep the area moist. Pseudoephederine may also help to clear any mucus that may cause coughing and thereby triggering more spasms.

WHAT TO DO: Because spasms tend to last a short time (in most cases, but are very scary and feel like they last a long time, holding your breath during the spasm is a strategy for dealing with the spasm until it is over. Holding your breath and putting saline drops while holding your head back can give the sufferer something to do to both help the situation and distract the sufferer.

Note: Some have gotten relief by breathing in cold air from the freezer or breathing very slowly through a straw. Taking tiny sips of ice water can help in some case of you can get it down. An ice cold wet rag on the throat may also help in some cases. The main thing is to keep as calm as you can and relax as much as possible. Hard to do when you cannot breathe, but it helps.

External links

-1999634387 at GPnotebook
emerg/802 at eMedicine "Ketamine: Emergency Applications" – discusses laryngospasm.^{[dead link]}
Information for patients with laryngospasm – voicedoctor.net
LaryngospasmInfo.com Symptoms, Treatment, Causes, and Resources for Laryngospasm.^{[dead link]}
Links, Information and Resources about Laryngospasm Laryngospasm Information Network.^{[dead link]}

UpToDate Contents

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English Journal

Distinct acoustic features in spinal and bulbar muscular atrophy patients with laryngospasm.

Tanaka S1, Banno H2, Katsuno M2, Suzuki K2, Suga N2, Hashizume A2, Mano T2, Araki A2, Watanabe H2, Adachi H2, Tatsumi H3, Yamamoto M3, Sobue G4.
Journal of the neurological sciences.J Neurol Sci.2014 Feb 15;337(1-2):193-200. doi: 10.1016/j.jns.2013.12.010. Epub 2013 Dec 11.
OBJECTIVE: Laryngospasm is a sudden onset of transient respiratory difficulty that is perceived as life-threatening by patients with spinal and bulbar muscular atrophy (SBMA). The purpose of the study was to analyze the voice characteristics of SBMA patients with laryngospasm using acoustic voice an
PMID 24361063

Safety and efficacy of propofol administered by paediatricians during procedural sedation in children.

Chiaretti A1, Benini F, Pierri F, Vecchiato K, Ronfani L, Agosto C, Ventura A, Genovese O, Barbi E.
Acta paediatrica (Oslo, Norway : 1992).Acta Paediatr.2014 Feb;103(2):182-7. doi: 10.1111/apa.12472. Epub 2013 Dec 3.
AIM: The aim of this study was to determine the safety and the efficacy of paediatrician-administered propofol in children undergoing different painful procedures.METHODS: We conducted a retrospective study over a 12-year period in three Italian hospitals. A specific training protocol was developed
PMID 24138461

[Clinical analysis of 4 children with negative pressure pulmonary edema].

Chen J1, Wang S, Ma H, Wang W, Fu D, Huang W, Deng J, Tang H, He Y, Zheng Y2.
Zhonghua er ke za zhi. Chinese journal of pediatrics.Zhonghua Er Ke Za Zhi.2014 Feb;52(2):122-7.
OBJECTIVE: To analyze the clinical characteristics of negative pressure pulmonary edema (NPPE).METHOD: A retrospective investigation of the clinical manifestation, imageology, clinical course and outcome of 4 children with NPPE seen between June 2012 and July 2013 in a children's hospital. The causa
PMID 24739724

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