日常生活中の反復性喉頭けいれん発作の７例

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  • 丸山 裕美子
    黒部市民病院耳鼻咽喉科
  • 古川 仭
    金沢大学大学院医学系研究科脳医科学専攻脳病態医学感覚運動病態学

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タイトル別名
  • Seven Cases of Laryngospasms in Everyday Life.
  • ニチジョウ セイカツ チュウ ノ ハンプクセイ コウトウ ケイレン ホッサ ノ 7レイ

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We report 7 cases of acute and recurrent inspiratory dyspnea in which no organic cause could be identified. Patients were from 12 to 68 years old (43.6 in average), consisting of five males and two females. In three of the seven cases, fiberoptic laryngoscopy during an attack of dyspnea revealed laryngospasms following symmetric adduction of the vocal cords. Each patient experienced loud, stridorous noise during inspiration at the beginning of an attack as well as the subsequent inability to inspire. The attacks ranged from several tenths of a second to a few minutes in duration and occurred frequently, several times a day in some cases. Results of physical examinations, lung function tests, roentgenograms of the chest and larynx, and CTs of the lungs and the neck were unremarkable. Laboratory findings including blood gas analysis between attacks were within normal limits. No atopic stigmata were found.<br>Drinking water or swallowing could sometimes relieve the grade of the attack, and the patient could completely prevent attacks once they understood the condition of the dyspnea and mastered a breathing maneuver during the attack. Previous upper respiratory infection, cough, and sleep apnea were suggested to correlate with the episodes. Our patients did not require drastic maneuvers such as tracheostomy or intubation. Administration of Eperisone hydrochloride and Etizolam proved effective in some cases.<br>Laryngospasm as a cause of recurrent inspiratory dyspnea is functional, and we suspect that it is not such a rare occurrence. An awareness of this entity could prevent unnecessary tracheotomies.

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