Spasmodic laryngeal dyspnea: a rare manifestation of laryngeal dystonia

Abstract

We describe clinical experiences in the management of three patients with laryngopharyngeal dystonia causing severe breathing problems. In contrast to spasmodic dysphonia, which presents with action-induced involuntary spasm of laryngeal muscles during speaking, all three patients showed laryngopharyngeal spasms primarily during respiration. In analogy to spasmodic dysphonia we propose the term spasmodic laryngeal dyspnea for this rare condition. Localized unilateral botulinum toxin injected into the thyroarytenoid muscle and/or ventricular folds reduced the quantity and quality of spasms and led to a pronounced improvement of breathing problems.

Spastic Facial Muscle Disorders

“…The voice may become harsh, hoarse, and strained, a condition termed "spasmodic dysphonia." (Zwirner et al 1997 ;Brin et al 1998 ) . Cervical muscle involvement, typical of "spasmodic torticollis," may accompany cranial dystonia; less often distal muscles, such as of the hand (as in "writer's cramp"), may be affected (Gordon 2005 ) .…”

Botulinum Toxin Therapy of Dystonia

“…Spasmodic laryngeal dyspnea describes spontaneously occurring or respirationinduced muscle hyperactivity of laryngeal muscles [ 67 ]. This condition is very rare and may infl uence both glottic and supraglottic muscles and can also be treated with BT therapy.…”

Sudden death in Lesch‐Nyhan disease

“…Laryngeal breathing dystonia has been reported to cause airway obstruction in other dystonic disorders. [12][13][14] This mechanism should be considered in all cases, as it can be treated with local injection of botulinum toxin.…”