What Causes Laryngospasm or Laryngeal Spasm & How is it Treated?

What is Laryngospasm or Laryngeal Spasm?

Laryngospasm or Laryngeal Spasm can be a terrifying experience for a person who experiences it. In Laryngospasm or Laryngeal Spasm, there is sudden seizing or closing of the vocal cords upon taking in a breath, leading to blockage of air flow into the lungs. Although a person experiences this condition rarely, whenever this episode occurs, it can frighten the affected person a lot. Individuals who experience laryngospasm or laryngeal spasm can be awakened from a deep sleep and find that they are unable to breathe or speak, which is a temporary albeit a scary feeling. Laryngospasm usually subsides in a couple of minutes and is not commonly a serious condition. Treating the underlying cause of laryngospasm or laryngeal spasm helps in resolving this condition.

What is Laryngospasm or Laryngeal Spasm

What Causes Laryngospasm or Laryngeal Spasm?

There are different triggers for laryngospasm or laryngeal spasm, such as allergies, asthma, exercise, irritants such as dust, smoke and fumes; anxiety, stress and often gastroesophageal reflux disease. GERD is a medical condition where the ring-shaped muscle in the stomach, which keeps the stomach’s contents from regurgitating back, fails to function properly. In GERD harsh acids present in the stomach regurgitate up into the esophagus and lead to irritation. Damage and inflammation to the esophageal lining can occur as a result of regular exposure to the stomach acids, which can in turn lead to momentary spasms of the vocal cords, which block the airway and prevent oxygen and air from entering the lungs resulting in an episode of laryngospasm or laryngeal spasm.

Laryngopharyngeal Reflux or LPR is a condition where the stomach acids reach the larynx. The laryngeal tissue is more delicate than the esophageal tissue and is more prone to damage and injury when compared to esophagus. If a patient has a cough and cold, this pushes more acid into the larynx. So, if a person has had an upper respiratory infection, then this increases the likelihood of having a laryngospasm.

Laryngospasm or laryngeal spasm can also occur as a complication of surgical anesthesia, which is used during a surgery. Anesthesia can cause irritation to the vocal cords, especially in children. Anesthesia which causes laryngospasm or laryngeal spasm can be a potentially life-threatening situation.

What are the Signs & Symptoms of Laryngospasm or Laryngeal Spasm?

Laryngospasm or laryngeal spasm causes a feeling of choking and an inability to speak. The episodes can also occur in the night. An individual can awaken suddenly from his/her sleep and feel as if they are suffocating. This is known as sleep-related laryngospasm or sleep related laryngeal spasm and is often associated with GERD. There are some individuals who can lose consciousness when these episodes occur.

After the episode of laryngospasm passes, the airways will open slowly and the patient will make a high-pitched breathing sound, which is known as stridor. This entire episode will last for only a minute or two and then the breathing returns back to normal. However, this whole experience or episode of laryngospasm or laryngeal spasm can be very terrifying for the affected person. Patient will often have symptoms of GERD along with the episode of laryngospasm including:

How is Laryngospasm or Laryngeal Spasm Treated?

  • Treatment for laryngospasm or laryngeal spasm comprises of treating the underlying condition which is causing it. If the cause of the laryngospasm is GERD, then treatment for this condition helps in managing laryngospasm. Proton pump inhibitors such as esomeprazole, dexlansoprazole and lansoprazole are prescribed. These medicines help in decreasing the stomach acid production, so the fluids which go back up into the esophagus are less harsh.
  • Prokinetic agents are another treatment option for laryngospasm or laryngeal spasm which stimulates the movement of the intestines, so that the amount of acid which is present is reduced.
  • Surgery for laryngospasm or laryngeal spasm may be needed for those patients who do not respond to the above mentioned treatment options. Fundoplication is a surgical procedure where the upper part of the stomach is wrapped around the esophagus thus preventing the acids from backing up.
  • A circle of titanium beads can also be attached surrounding the lower esophagus. This helps in strengthening the valve between the stomach and the esophagus and still allows the liquids and food to pass through.
  • Treatment in children, who develop laryngospasm or laryngeal spasm occurring as a complication of anesthesia during surgical procedures, comprises of trying to open the airway by moving the head and neck.
  • CPAP or continuous positive airway pressure helps in delivering the air directly into the airway with the help of a machine. In some cases, a tube needs to be placed into the throat to help with the breathing.

Lifestyle Modifications for Preventing Laryngospasm or Laryngeal Spasm

Laryngospasm or laryngeal spasm can be prevented by relieving the GERD and LPR. The following lifestyle modifications should be undertaken:

  • Eating smaller meals helps in preventing indigestion and also preventing laryngospasm or laryngeal spasm. Heavy meals should be avoided right before bedtime and preferably should be taken 2 to 3 hours before bedtime.
  • Common triggers for heartburn, such as fruit juices, fruits, fatty foods, caffeine and peppermint should be avoided.
  • Smoking and drinking alcohol should be avoided.
  • Allergy triggers should be avoided.
  • Elevating the head of the bed by a few inches by placing some wooden blocks under the bedpost helps in relieving GERD.
  • Stress can be beaten by practicing relaxing breathing techniques, such as slow breathing which will help in staying calm and in preventing laryngospasm or laryngeal spasm.
Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:April 28, 2022

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