Carbon dioxide inhalation challenges in idiopathic environmental intolerance

Poonai, Naveen; Antony, Martin M.; Binkley, Karen; Stenn, Peter; Swinson, Richard P.; Corey, Paul; Silverman, Frances; Tarlo, Susan M.

doi:10.1016/s0091-6749(00)90088-5

Cited by 52 publications

(41 citation statements)

References 34 publications

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“…Finally, Poonai and colleagues conducted CO 2 inhalation challenges on 36 subjects with IEI and 37 healthy controls (see accompanying article by Tarlo). The two groups differed significantly in their scores on the Anxiety Sensitivity Index (IEI subjects scoring higher), and significantly more IEI than control subjects reacted to CO 2 provocation with paniclike symptoms (71 vs. 26%; p < 0.001) (43).…”

Section: Odor-triggered Panic Attacksmentioning

confidence: 91%

Review of the upper airway, including olfaction, as mediator of symptoms.

Shusterman

2002

Environ Health Perspect

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Section: Odor-triggered Panic Attacksmentioning

confidence: 91%

Review of the upper airway, including olfaction, as mediator of symptoms.

Shusterman

2002

Environ Health Perspect

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“…Intubation, certain anaesthetics, GER and various other aetiologies have been implicated in inducing laryngospasm [17,29,44]. Finally, there are functional disorders that must be distinguished from VCD, including spasmodic or muscle tension dysphonia, panic attacks, Munchausen's syndrome [45] and multiple chemical sensitivity (idiopathic environmental intolerance) [46][47][48] and somatoform disorders [49].…”

Section: Differential Diagnosismentioning

confidence: 99%

Vocal cord dysfunction: what do we know?

Kenn

Balkissoon²

2010

European Respiratory Journal

145

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Vocal cord dysfunction (VCD) is a disorder caused by episodic unintentional paradoxical adduction of the vocal cords, which may induce acute severe dyspnoea attacks not responsive to conventional asthma therapy. The aetiology of VCD is complex and often multifactorial. The essential pathophysiology is that of a hyperfunctional laryngeal reflex to protect the lower airway as a result of any combination of post-nasal drip, gastro-oesophageal reflux, laryngopharyngeal reflux and/or psychological conditions. Laryngoscopic demonstration of the paradoxical motion while wheezing or stridorous is considered the diagnostic gold standard. Speech therapy, including the use of special relaxed-throat breathing patterns is effective for VCD that is purely of the functional nature. Knowledge of the clinical features of VCD and identifying factors that may be contributing to the development of VCD can provide adequate clues to the correct diagnosis and management.

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“…Supposedly, unnamed stressors or an unidentified disturbance in both patient and family play significant roles in VCD pathogenesis. [5,[35][36][37].…”

Section: Discussionmentioning

confidence: 99%

Vocal Cord Dysfunction after an Inhalation Exposure

Brooks¹

2017

J Allergy Ther

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The manuscript embodies case material and the author's extensive personal experience to address a perceived or actual airborne exposure when incorrectly judged as due to intrathoracic/lung damage when in reality the outcome is the more innocuous extrathoracic/upper airway's vocal cord dysfunction (VCD). Because of the conviction of possible lung injury, the individual applies the fetal protective glottic closure reflex to counteract an odorant cue instigating acute VCD. Breathing against an obstructed glottis as well as hyperventilation from anxiety, panic and/or fear of personal harm worsens the laryngeal spasm. Spirometer shows flattening of the inspiratory loop of the flow-volume curve and endoscopy, while not done, would reveal adduction of the anterior two-thirds of the vocal cords with posterior chinking creating a diamond shape configuration. Successful therapy and management of VCD requires a speech therapy approach rather than physician prescribed medications.

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Carbon dioxide inhalation challenges in idiopathic environmental intolerance

Cited by 52 publications

References 34 publications

Review of the upper airway, including olfaction, as mediator of symptoms.

Review of the upper airway, including olfaction, as mediator of symptoms.

Vocal cord dysfunction: what do we know?

Vocal Cord Dysfunction after an Inhalation Exposure

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