Causes of laryngospasm in adults and children

Thanks to numerous studies, the main causes that cause spontaneous spasm of the larynx are established:

• Changing the reactivity of the body.
• Excessive excitability of the reflex neuromuscular apparatus of the larynx.
• Metabolic disorders of the body.
• Deficiency of vitamin D and calcium salts.
• Congenital anomalies of the respiratory system and birth trauma.
• Pathological changes in the elements of the respiratory system: trachea, lungs, pharynx.
• Great stress or fright.
• Coughing attacks.
• Allergic reactions.

The disorder can develop on the background of other diseases:

• Bronchopneumonia.
• Spasmophilia.
• Chorea.
• Dropsy of the brain.
• Rahith.
• Lesions of the gallbladder, pharynx, pleura, larynx, trachea.
• Tombstone.
• Eclampsia.
• Dorsal dry (tertiary syphilis).

In adults, laryngospasm is most often associated with such factors:

• The effects of air with irritants or allergens.
• Effects on the larynx of drugs.
• Infringement of tumoral neoplasms.
• Oedematous and inflammatory processes in the larynx.
• Irritation of the recurrent laryngeal or vagus nerve.
• Stressful experiences with increased excitement.

Very often laryngospasm occurs in people living in industrial areas, where the air contains a lot of irritating elements.

Spasmophilia and laryngospasm

The tendency to the occurrence of seizures, muscle twitchings and spasms associated with a deficiency of calcium and vitamin D in the body is spasmophilia. Most often, the disease develops at the age of 1-3 years, but in some cases it occurs in adults.

Spasmophilia has several types:

1.  Explicit form - can occur in several variants, which arise separately or simultaneously.
   • Laryngospasm - acute spasm of the glottis. The larynx completely or partially narrows. Causes breathing disorders, voice changes. The attack lasts about 2-3 minutes. It requires urgent care, as it can cause life-threatening complications.
   • Carppedal spasm is spasmodic and hypertonic brushes, feet. The disorder lasts from a couple of minutes to several hours.
   • Eclampsia is the most severe form of the disease. It is manifested by rare breathing and numbness of the whole body. As progression occurs, spasms, involuntary urination and biting of the tongue. The attack lasts for several hours.
2.  The latent form - has an asymptomatic course, the problem can be identified only through a comprehensive diagnosis. Effects on the body of severe stress, pathologies of infectious nature and other factors lead to the transition of the disease into an explicit form.

Spasmophilia and laryngospasm in adults is less common than in children. The main causes of the violation are:

• Extraction of parathyroid glands.
• Pregnancy and lactation.
• Tumor neoplasms.
• Infectious diseases.
• Nervous overvoltage.
• Hemorrhages.

Diagnosis consists of a set of different methods: collection of anamnesis, visual examination, laboratory tests (blood test for calcium level) and instrumental studies (ECG, MRI). Treatment depends on the severity of the disease state. First of all, they carry out emergency care. The patient is placed on a flat surface and removes the chest tight clothes, provide fresh air. The face and skin are sprinkled with cold water, ammonia is added.

In case of an acute attack, medical care is necessary. Doctors enter intravenously calcium gluconate or a 10% solution of calcium chloride. Continuous monitoring of the heart rate is also shown. Without timely treatment, there is a risk of complications: convulsions, respiratory failure, cardiac arrest.

Allergic laryngospasm

Noninfectious inflammatory process in the larynx with spasms of its walls is an allergic laryngospasm. It occurs because of various allergens and irritants. Very often, this type of disorder is called a special form of inflammation, since it is not associated with viruses or bacteria. Inflammatory reaction leads to a sharp weakening of local immunity, which entails aggravation of laryngitis.

The organism of each person is individual, therefore it reacts differently to various stimuli. The main provoking factors include:

• Household allergens - animal hair, washing and cleaning products, hygiene products, cosmetics.
• Natural allergens - the smell of plants, pollen, fluff.
• Food products - fruits of red color, honey, chocolate, nuts, sour-milk products, eggs, artificial additives and sweeteners.
• Medication - antibiotics, anesthetics, vaccines, serums, vitamins, sedatives.
• Industrial pollutants.

The appearance of a painful condition contributes to hypothermia, the use of hot or too cold drinks. Often in adults, allergic attacks occur due to work in hazardous production or in dusty premises.

Symptoms of spasms of the larynx of an allergic nature:

• Difficulty breathing due to narrowing of the glottis.
• Shortness of breath and painful swallowing.
• Hoarseness and hoarseness of voice.
• Burning, itching and dryness in the throat.
• Coughing and perspiration.

Also, a painful condition can be accompanied by rhinitis or rhinopharyngitis. If local immunity is disturbed and the allergen affects the body for a long time, chronic infectious foci form in the oropharynx and nasal cavity. This leads to the development of laryngitis, which is characterized by fever, cough with phlegm, pain in the throat and general intoxication.

Every time contact with an allergen causes spasms of the larynx. To establish the cause of the disorder, a number of diagnostic manipulations are shown: general clinical studies, analysis for allergic tests, laryngoscopy. There is a mandatory differentiation with viral inflammation of the larynx, tracheitis, diphtheria.

Treatment depends on the severity of the seizures. The patient may be referred to a hospital. On average, the course of treatment takes about 10 days. The patient is prescribed antihistamine and desensitizing drugs, glucocorticosteroids, antispasmodics. If the breath can not be restored, the trachea is intubated. After recovery, repeated allergic tests are performed, this is necessary to prevent recurrence of the disease.

[1], [2], [3], [4], [5], [6]

Laryngospasm in narcosis

Complications of anesthesia arise due to various factors:

• Underestimation of operational risk.
• Wrong choice of anesthesia.
• Reaction to medications.
• Errors during operational or diagnostic manipulations.

One of such complications is laryngospasm. In anesthesia, the clamping of the vocal cords leads to the fact that the patient can not inhale air, and the exhalation is significantly hampered. If the spasm is incomplete, then a characteristic sound appears during inspiration.

The pathological state is the result of local irritation or manifests itself in a reflex. It can occur at the beginning of anesthesia, that is, by inhalation of cold ether vapors. In this case, the spasm is associated with a high concentration of ether, irritation of the larynx by mucus, an intubation tube or food masses. Most often, spasms occur with barbituric anesthesia.

Reflex laryngospasm is formed during surgical manipulations on reflexogenic zones: solar plexus, sipping over a mesentery or stomach.

To prevent spasms from anesthesia, the following activities are shown:

• After anesthesia has affected, the patient is administered Atropine and Promedol.
• The ether concentration is increased gradually to avoid irritation of the laryngeal mucosa.
• During the introduction of barbituric anesthesia, the patient must breathe oxygen. Intubation is carried out in deep sleep. The airway is not injected if the pharynx and root of the tongue are not previously lubricated with Dicain.
• With the likelihood of reflex spasms, at the most traumatic moments, anesthesia is deepened or Novokain is injected into the surgical wound.

If the spasm of the larynx during anesthesia has occurred, then the narcotic drug is discontinued and pure oxygen is injected until the spasms are completely eliminated. If there is a need for intubation and artificial ventilation with pure oxygen, then short-acting muscle relaxants are injected. If intubation is not possible, and laryngospasm is held, the doctor performs a puncture of the thyroid-cricoid ligament with a thick needle and through it injects oxygen / air. In especially severe cases, an emergency tracheotomy is performed. It is necessary to reduce oxygen starvation.

Laryngospazm when exuberating

Extubation is the extraction of the intubation tube after anesthesia. The procedure is performed when the patient breathes normally, that is, after restoration of consciousness and reflexes. One of the complications that can occur with extubation is laryngospasm.

Spasmodic larynx is a reflex due to irritation of the respiratory tract. The disorder is manifested by "croaking" sounds during inspiration, the paradoxical movement of the thoracic and abdominal cells, expressed by the westernization of the suprasternal space. If there is a complete violation of patency, the patient is unable to breathe in. Without emergency medical care, this can lead to post-obstructive pulmonary edema, hypoxic cardiac arrest, and death.

In order to minimize the risk of developing laryngospasm, extubation is performed with superficial anesthesia. Local application of lidocaine in the form of an aerosol on the vocal cords during the introduction of anesthesia, reduces the risk of spasms.

Laryngitis and laryngospasm

Acute diseases with violation of patency of the respiratory tract in the larynx and the development of respiratory failure is a stenosing laryngitis. Laryngospasm acts as one of the symptoms of a painful condition.

Inflammation of the larynx very often develops against the background of acute respiratory disease or influenza, prolonged exposure in a dusty room, under hypothermia. Also, stenosing laryngitis is associated with viral and viral-bacterial infections.

On the mucous membranes of the throat, clumps of phlegm and mucus form which cause shortness of breath and disturb breathing. There are also a number of other symptoms:

• Difficulty breathing (stenotic breathing).
• Change of voice, hoarseness.
• Rough cough.

Spasms appear suddenly, provoking coughing attacks, noisy breathing, blanching of the skin. Treatment is aimed at eliminating the factors causing the disorder. Patients are prescribed bronchodilators, inhalations. It is necessary to refrain from smoking and drinking alcohol, which irritates the laryngeal mucosa. If the disease occurs in an acute form with frequent attacks, difficult to treat, then you should immediately seek medical help.

Reflex laryngospasm

More often reflex spasm of the larynx occurs in children due to artificial feeding, rickets, dropsy of the brain. In adulthood, reflex irritation is associated with ingestion of foreign bodies into the larynx, diagnostic or surgical manipulations, tumor neoplasms and other factors.

One of the most common causes is the increased excitability of the neuromuscular apparatus of the larynx. Spasms of the larynx can be triggered by psychogenic disorders and occur with severe stress and anxiety.

During an attack the scaly patches are reduced to the middle line, and the vocal cords are tightly closed. Because of this, there are such symptoms:

• Noisy breath and shallow breathing.
• The person can not clear his throat.
• Skin covers acquire a cyanotic shade.
• The nasolabial triangle is distinctly prominent.
• Tense muscles of the face, neck and abdomen.
• A half-open mouth, the head is thrown back.
• Weakness of pupils' reaction to light.

Attacks are characterized by an unexpected appearance. Without timely medical care, the above symptoms can cause loss of consciousness, convulsive seizure, involuntary urination, oppression of cardiac activity. As a rule, the spasm quickly stops on its own, resembling an epileptic seizure. A prolonged attack without emergency care can lead to death from asphyxia.

Laryngospasm with epilepsy

Serious disease of the nervous system with sudden epileptic seizures because of an abnormal, super-strong electrical discharge in one of the brain regions is epilepsy. Annually, this pathology is revealed in 5-7 people out of 10 thousand. The peak incidence falls on the period of puberty and the age of 60-75 years.

There are many causes and factors that can trigger the development of pathology. The disorder has several types, each of which is characterized by certain manifestations. The appearance of laryngospasm most often indicates temporal epilepsy. Its appearance is associated with birth trauma, brain damage as a result of trauma or inflammatory processes.

• During the attack, all muscles contract and the person loses consciousness.
• For a couple of seconds, breathing stops due to spasm of the muscles of the larynx and the diaphragm.
• An acute fit lasts no more than a minute.
• After the tonic phase, the muscle contractions begin alternating with relaxation. At this point, foam may appear from the mouth.
• Seizures last about 3-5 minutes, after which there is a post-attack period, when the patient falls asleep.
• Due to excessive relaxation of the muscles, involuntary urination or defecation is possible.

The main feature of epileptic seizures with laryngospasm is that the patient feels their approach. The disease is characterized by a chronic course with gradual progression. If the seizures go one after another without stopping, the spasms of the respiratory muscles lead to a persistent stop of breathing, oxygen starvation of the brain and death.