Laryngospasm: causes and symptoms

By Cristiano Antonino On Oct 24, 2022

Laryngospasm is a temporary condition that prevents normal breathing for a few seconds, causing choking attacks, and then resolves spontaneously

It can be caused by inflammation, infection or allergies.

What is laryngospasm

Laryngospasm is a pathological condition affecting the upper airways caused by spasmodic contraction of the muscles of the larynx in response to stimuli of various kinds.

This contraction presents itself as sudden, involuntary and uncontrolled and can also extend to the vocal cords, causing an obstruction to airflow, hence the sense of suffocation that the patient complains of during seizures.

The duration is variable, ranging from a few seconds to several minutes and even hours, more frequent at night.

The larynx is located between the pharynx and the trachea and has walls formed by ligaments and muscles that serve to articulate the cartilages.

Generally, laryngospasm is the manifestation of an irritation caused by an airway infection – usually viral in nature – in individuals who are more prone to this type of reaction.

It tends to occur especially during cold periods in children as they are ‘more susceptible’ to common airway infections (colds, flu, bronchitis), but also in allergy sufferers or hyperactivity of the bronchi (such as in asthmatics).

Causes of laryngospasm

Laryngospasm can occur in various situations.

The main causes are:

Respiratory tract infection: during a laryngitis (viral species but also bacterial), the inflammatory process can irritate the laryngeal musculature causing it to spasm. In addition, laryngitis can also cause inflammation secondary to infection and cause oedema (increased volume) of the laryngeal mucosa, further reducing the space available for the passage of air;
Respiratory allergies and allergic laryngitis: the allergic reaction can cause oedema of the glottis associated with laryngeal spasm, drastically reducing the pathway for the passage of air. Like asthma (both allergic and non-allergic), it is a respiratory disorder characterised by bronchospasm and increased airway resistance;
Gastro-oesophageal reflux: this is a pathology characterised by the ascending of acidic gastric juice from the stomach to the oesophagus, up to the larynx. During the ascent, the acid material irritates the oesophageal mucosa (causing reflux oesophagitis) and the laryngeal mucosa (causing reflux laryngitis and sometimes temporary laryngospasm). This condition typically occurs during the night hours and can also cause apnoea crises. In infants up to 3 years of age, gastro-oesophageal reflux can also cause very severe apnoea episodes;
Inhalation of elements: Toxic substances such as smoke and environmental pollutants, but also sea water, foreign bodies or objects and small toy parts (inhaled mainly by children) if inadvertently inhaled can cause episodes of laryngospasm.

How can one recognise laryngospasm?

The typical symptoms that generally accompany the onset of laryngospasm are

difficulty breathing with a feeling of air hunger, such as choking
noises during breathing such as wheezing, hissing and whistling;
continuous convulsive, barking-type coughing;
tachycardia, increased respiratory rate, sweating with inability to speak.

The respiratory crises, whose duration varies from a few minutes to several hours, end more or less as suddenly as they began, until the next onset occurs again, e.g. the following night.

In the case of sporadic laryngospasm (from unknown causes) lasting only a few seconds, no treatment is indicated as the symptom resolves on its own.

In the case of those with a definite cause, treatment will be aetiological and generally involves drugs such as cortisone, administered by aerosol, or oxygen therapy and mechanical ventilation.

When medical intervention is necessary

This condition causes considerable anxiety for parents when it affects young children with frequent laryngospasm crises.

Continued crises can affect the child’s general condition, as breathing difficulties represent a considerable physical effort and are accompanied by lack of appetite, exhaustion and vomiting caused by an insistent cough.

The doctor’s assessment is essential to identify the causes of laryngospasm, especially infectious ones, and to choose the most suitable pharmacological therapy.

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