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[Episodic laryngeal dysfunction].

G Roger1, F Denoyelle, E N Garabedian

  • 1Service d'ORL pédiatrique, hôpital d'enfants Armand-Trousseau, 26, avenue A. Netter 75012 Paris, AP-HP, université Paris-VI, Paris, France. gilles.roger@trs.ap-hop-paris.fr

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|October 31, 2001
PubMed
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Episodic laryngeal dysfunction (ELD), or paradoxical vocal cord dysfunction, involves abnormal vocal cord closure during breathing. Diagnosis hinges on symptom reversal with distraction, and behavioral treatment is preferred over medical intervention.

Area of Science:

  • Laryngology
  • Pediatric Pulmonology
  • Respiratory Medicine

Context:

  • Episodic laryngeal dysfunction (ELD), also known as paradoxical vocal cord dysfunction, presents with inspiratory stridor and dyspnea.
  • Manifestations vary by age, from neonatal stridor to pseudo-asthma in older children.
  • Gastroesophageal reflux and vasovagal attacks can be associated comorbidities.

Purpose:

  • To describe the clinical presentation, diagnosis, and management of episodic laryngeal dysfunction (ELD).
  • To highlight diagnostic challenges, particularly differentiating ELD from asthma.
  • To emphasize behavioral management strategies.

Summary:

  • ELD is characterized by abnormal vocal cord closure during inspiration, often misdiagnosed as asthma.

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  • Key diagnostic feature is symptom resolution with distraction; exertion-induced forms exist.
  • Treatment focuses on behavioral interventions, avoiding hospitalization and tracheotomy when possible.

    • Impact:

    • Improved recognition of ELD can prevent unnecessary medical interventions like tracheotomy.
    • Understanding ELD's varied presentations aids in accurate diagnosis and appropriate management.
    • Behavioral therapy offers an effective, non-invasive treatment approach for ELD.