Laryngospasm refers to an involuntary contraction of the muscles of the larynx, the duct through which air passes to reach the lungs

This state leads to the only momentary closure of the glottis (the glottis is the upper opening of the larynx, interposed between the vocal cords), which causes a feeling of suffocation and oppression in the patient.

As mentioned above, laryngospasm is usually a temporary condition

It resolves within a few seconds and rarely spends a few minutes.

It then resolves spontaneously and the patient returns to breathing normally, although it is an experience experienced as ‘frightening’ in most cases.

The patient feels suffocated; these are moments of fear.

The symptoms of laryngosapism

The fear that arises from laryngospasm lies in the unpredictability of its symptoms, which causes the patient to experience moments of terror.

The sensation is that of sudden suffocation and inability to breathe.

The symptoms generally last a few seconds and resolve naturally.

The main ones in cases of laryngospasm are

• difficulty breathing with a feeling of air hunger
• wheezing, hissing and whistling;
• choking sensation;
• increased heart rate;
• continuous convulsive coughing;
• profuse sweating;
• increased respiratory rate;
• inability to speak;
• possible fainting.

Causes of laryngospasm

Various factors can cause laryngospasm, from allergies to infections, asthma, etc.

We analyse them in more detail below.

Certainly the reason for a laryngospasm attack could be an allergic reaction or anaphylactic shock.

During one of these reactions, the glottis swells, often associated with laryngeal spasm, and this results in the restriction of the air passage channel.

In the most severe cases, in which bronchospasm may also occur, asphyxia and death may occur.

Respiratory tract infection

This can lead to inflammation of the laryngeal musculature and eventually to spasm, in the case of viral or bacterial laryngitis.

Inflammation and oedema also swell the laryngeal mucosa, further reducing the space available for the passage of air.

Diseases of the larynx

Laryngitis, diphtheria, laryngeal cancer, and laryngeal haemorrhage are all larynx-related diseases, which can lead to laryngospasm.

Asthma

Asthma is characterised by bronchospasm and increased airway resistance.

There are different types of asthma, such as allergic and non-allergic.

The first is the consequence of allergies to pollen, e.g. flour, animal hair, dust.

The second can be caused by excessive physical exertion, respiratory infections, smoking or a reaction to certain types of drugs.

General anaesthesia

The use of certain drugs to initiate general anaesthesia or certain endotracheal intubation practices can, in some cases, cause laryngospasm.

This situation, if it occurs, is very dangerous in children.

Toxic substances or inhaled foreign bodies

Cigarette smoke, inhalation of pollutants or toys or foreign bodies in children can be triggers for laryngospasm.

Drowning

In the case of drowning, when water enters the respiratory tract, our body activates a form of defence with a very strong laryngospasm that stops the entry of water.

Gastro-oesophageal flow disorders

This is the rise of acid material from the stomach up the oesophagus into the oral cavity.

During this phase, the acid material irritates the oesophageal mucosa and the laryngeal mucosa.

This can lead to reflux laryngitis and sometimes to temporary laryngospasm.

Complications of laryngospasm

If the laryngospasm attack is severe and does not resolve within a few seconds, serious consequences may ensue such as:

• cyanosis;
• hypoxia, i.e. reduced oxygen levels in the blood;
• turgidity of the veins in the neck;
• convulsions;
• cardiac arrest,
• asphyxia;
• death.

In the event of symptoms that do not abate, it is good practice to contact the nearest emergency room immediately.

Laryngospasm in children

Laryngospasm can occur in the first 3-5 years of a child’s life, with these particular signs

• it may occur at night while the child is sleeping. His or her awakening will be sudden, with severe coughing and agitation. Breathing noises appear, the child starts to cry with increased respiratory rate and accentuated chest movements. Over time, cyanosis may appear, i.e. bluish discolouration of the fingers and lips. Fortunately, this is a situation that generally resolves within a few seconds, despite the great concern that the child and parents may experience during those moments.
• with symptoms similar to those of an adult, but in addition nausea, vomiting, lack of appetite, and incosolable crying.

In these cases, the parent should be able to keep calm, take their child in their arms and try to calm them down while waiting for the spasm to cease.

These are usually moments of fear that fortunately last only a few seconds. If the problem persists or the episodes of laryngospasm become more frequent, it is absolutely important to seek medical attention or go to the nearest emergency room.

Treatment

As in most cases, if the laryngospasm lasts a few seconds, there is no need to start any treatment or take anything on the spot.

If, on the other hand, it is intense, lasts a few minutes or occurs frequently, it is advisable to consult a doctor, who will initiate an aetiological treatment, i.e. aimed at removing the underlying cause.

The specialist will prescribe, in particular

• cortisone in case of severe allergic reaction and combination with adrenaline in case of anaphylactic shock;
• oxygen therapy;
• assisted mechanical ventilation;
• resuscitative manoeuvres.

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