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Laryngospasm in amyotrophic lateral sclerosis.

Ryan D Gotesman1,2, Emilie Lalonde2, Douglas A McKim3

  • 1Department of Medicine (Neurology), The Ottawa Hospital, and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

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|November 24, 2021
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Summary

Laryngospasm affects 4% of amyotrophic lateral sclerosis (ALS) patients, often triggered by saliva or eating. Recognizing its features and triggers can improve care for these patients.

Keywords:
ALSbulbar dysfunctioncase seriesclinical managementlaryngospasm

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Area of Science:

  • Neurology
  • Pulmonology
  • Gastroenterology

Background:

  • Laryngospasm, an involuntary vocal cord closure causing dyspnea, is an underrecognized symptom in amyotrophic lateral sclerosis (ALS).
  • Understanding laryngospasm's prevalence and characteristics in ALS is crucial for improved patient management.

Purpose of the Study:

  • To determine the prevalence of laryngospasm in amyotrophic lateral sclerosis (ALS) patients.
  • To characterize the clinical features, triggers, and potential coping mechanisms associated with laryngospasm in ALS.

Main Methods:

  • Retrospective review of medical records for 571 ALS patients diagnosed between 2008 and 2018.
  • Identification and data extraction for 23 patients diagnosed with laryngospasm.

Main Results:

  • Laryngospasm was identified in 4% of ALS patients, predominantly females (57%) with a mean age of 63.4 years.
  • Laryngospasm frequently occurred with moderate bulbar dysfunction, independent of respiratory function. Common triggers included saliva irritation (35%) and eating (17%).
  • Varied frequency and duration of episodes were noted; drinking water was an effective coping mechanism for 13% of patients.

Conclusions:

  • Laryngospasm, though infrequent, warrants inclusion in ALS symptom assessment due to its association with bulbar dysfunction.
  • Recognizing laryngospasm's clinical features and triggers can enhance patient care and inform management strategies.
  • Further research is needed to elucidate the pathophysiology and optimal treatments for laryngospasm in ALS.