Laryngospasm

Laryngospasm
Classification and external resources
Specialty	pulmonology
ICD-10	J38.5
ICD-9-CM	478.75
MeSH	D007826
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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.

It is likely that more than 10% of drownings involve laryngospasm, but the evidence suggests that it is not usually effective at preventing water from entering the trachea.

Various stimuli including Astma allergies, exercise, stress and irritants such as smoke, dust, fumes, liquids and food can trigger laryngospasm. It is common in drowning, both as a direct response to inhalation of water, and as a complication during rescue and resuscitation due to aspiration of vomit.

In some individuals laryngospasm 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 sufferer. This usually occurs when the person has gastric acidity and develops re-flux during sleep, where the gastric acid causes irritation which will cause the spasm attack.

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