Laryngospasm in children and adults - symptoms, treatment, help, causes

Laryngospasm in a child

Laryngospasm is a sharp involuntary contraction of the muscles of the larynx, which leads to partial closure of the airways or to their complete obstruction.

As a rule, it does not require medical intervention during an attack, but in some cases it can lead to serious complications and even death.

It occurs in both adults and children from a very early age. Emergency care for laryngospasm is necessary, and it can be provided by a non-specialist.

Factors that provoke illness in a child

The development of the disease occurs primarily as a consequence of increased excitability of the nerve and muscle endings of the larynx. Factors that provoke the occurrence of the disease are:

• metabolic disorder;
• lack of vitamin D and calcium in the body;
• changes in the reactivity of the child’s body;
• consequences of various diseases: rickets, bronchopneumonia, chorea, hydrocephalus, spasmophilia;
• postpartum or mental trauma.

In addition, the causes of laryngospasm may be associated with dust and other components of an irritating nature entering the respiratory tract along with inhaled air, the use of certain medications to treat the throat and any other irritation of the nerve endings of the larynx. In addition, illness can occur in a child when laughing, coughing, crying, being scared, when choking on something, and in case of tetanus.

How to give first aid

Due to the high risk of complications and death, emergency care should be provided during an attack.

At home you need to do the following:

1. Eliminate the influence of perceived irritants. If you suspect that a foreign object has entered the larynx, tilt the victim's head down and shake vigorously.
2. Place the patient's back on a hard, smooth surface and keep the room as quiet as possible.
3. Organize ventilation in the room so that fresh air constantly enters the respiratory tract. If necessary, you need to give the baby artificial respiration.
4. Reflexively try to relieve the spasm by deliberately provoking irritation of the nasal mucosa or by applying ammonia.

The measures listed above help with minor spasms, but more severe attacks of laryngospasm may require medical attention. After providing first support, you should call an ambulance to prevent possible complications.

Symptoms of laryngospasm in children

In children, laryngospasm manifests itself in the form of spasms affecting the muscular laryngeal apparatus, which are sudden in nature. In order to promptly identify this condition, the following symptoms of laryngospasm should be taken into account:

• difficult, wheezing, noisy breathing;
• the appearance of cyanosis and pale complexion;
• neck muscle tension;
• connection to the implementation of inhalation and exhalation of the muscles of the auxiliary row.

During spasms, the sick child throws his head back, opens his mouth wide, cold sweat appears and respiratory processes stop for a while. Often the duration of muscle contractions is insignificant and lasts only a few seconds, and then, after that, carbon dioxide accumulates in the body, irritating the respiratory centers, as a result of which the respiratory processes are restored.

Main and accompanying symptoms

As a rule, a throat spasm is accompanied by the following symptoms:

breathing is difficult, noisy (inspiratory dyspnea); severe painful tension in the neck muscles; inability to swallow, feeling of a lump in the throat (characteristic of a spasm of the pharynx, not the larynx); pallor of the skin, with prolonged spasm giving way to cyanosis; cold sweat.

A slight spasm goes away on its own after a couple of minutes, breathing returns to normal, and swallowing function is restored.

In severe cases, a spasm of the throat, if not relieved in a timely manner, is accompanied by general convulsions, foam at the mouth, and can lead to loss of consciousness, weakening of cardiac activity and even death due to suffocation.

If a spasm is a reaction to an external stimulus: food, liquid, air, medicine, its cause is easy to establish. When the cause lies in diseases, an analysis of the accompanying symptoms will help identify the specific one.

With sore throat, laryngitis and pharyngitis, the spasm is accompanied by difficult painful swallowing, hoarseness, the main symptom is pain and sore throat. A spasm of the throat may be one of the manifestations of an allergy, while other symptoms must be present: itching, sore throat causing a painful cough, runny nose with sneezing and clear discharge from the nose, lacrimation and pain in the eyes. Dysfunction of the digestive system associated with abnormal contraction of the sphincters, which causes the reflux of gastric juice into the esophagus (gastroesophageal reflux, reflux esophagitis), is always accompanied by heartburn, and a lump in the throat appears as a result of irritation of the pharynx with acid.

Diaphragmatic hernia, often associated with obesity, is manifested by spasms in the throat, belching, and sometimes vomiting after eating, as well as pain in the chest and hypochondrium, aggravated by bending over. An enlarged thyroid gland (goiter) in the early stages is accompanied by sweating, increased fatigue, weakness and irritability, stool disorders and menstrual irregularities, rapid heartbeat and hand tremors. With further growth of the thyroid gland, spasms in the throat may occur. Psychoneurological disorders, in addition to numbness of the larynx, difficulty breathing, may be accompanied by dry mouth, difficulty swallowing saliva outside meals, loss of voice, complete or partial, behavioral changes, irritability, hysteria, anxiety, problems in communication. So-called panic attacks with a feeling of a coma in throat, which does not allow you to swallow saliva, nausea and rapid heartbeat are characteristic of neurosis and vegetative-vascular dystonia. Frequently recurring throat spasms, progressive difficulties with swallowing, combined with rapid weight loss, can signal the development of a serious disease - a tumor of the esophagus. Aortic aneurysm manifests itself with different symptoms, depending on the location. Shortness of breath and suffocation most often develop with an aneurysm of the aortic arch; due to compression of the trachea, bronchi, and lower laryngeal nerve, this condition is accompanied by a dry cough, hoarseness, and hemoptysis. Attacks of shortness of breath can also occur with an aneurysm of the ascending aorta, accompanied by dull chest pain. Throat cramps are often observed in patients after a stroke as a result of dysregulation of respiratory and swallowing functions, but usually disappear after a set of rehabilitation measures.

Providing emergency care to children

If a child experiences laryngospasm, he or she needs immediate assistance. Measures to provide emergency care to children during seizures include the following.

First of all, if laryngospasm occurs in an infant, he needs to be unswaddled to ensure air flow to him. An older child should be undressed: unbutton the collar and provide him with fresh air. In case of prolonged spasms, ventilation of the lungs is performed using the “mouth to mouth” method, and it is also necessary to do a cleansing enema. After this, you should call an ambulance.

Upon arrival, specialists will give the child a number of drugs such as magnesium sulfate, Si-bazon, Relanium, and hospitalize him.

While waiting for emergency doctors to arrive, you must:

• calm the child;
• put the child on a hard surface, since laryngospasm may cause heart rhythm disturbances, respiratory arrest, and cardiac massage may be required;
• ventilate the room and free the patient’s breathing by unbuttoning clothes;
• create a quiet environment;
• moisten the child’s face with water;
• stop spasms by inducing a vomiting reflex;
• If necessary, perform indirect cardiac massage.

Symptoms of laryngotracheitis and treatment in adults

There are several symptoms of laryngotracheitis in adults. According to the course, the form of the disease is divided into chronic and acute. When the disease is severe, the following symptoms can be observed:

1. Burning, dry larynx;
2. Soreness of the cervical lymph nodes;
3. Swelling of the laryngeal mucosa;
4. Attacks of dry cough when inhaling dust;
5. Hoarseness of voice;
6. Sore throat;
7. Significant increase in temperature.

As inflammation progresses, the cough becomes wet, painful, and mucopurulent sputum appears.

Symptoms of chronic laryngotracheitis:

1. Minor sputum discharge;
2. Pain in the larynx and chest, which gets worse when coughing;
3. Aphonia, hoarseness of voice.

The course of the acute process differs from the chronic one. A lower intensity of inflammation of the trachea is observed with a long course of the pathology. The inflammatory process is exacerbated by increased loads, severe stress, hypothermia, loud singing, screaming.

Croup is a sign of acute stenosing laryngotracheitis, accompanied by hoarseness, barking cough, and inspiratory dyspnea. The following symptoms are typical for croup:

• Barking cough;
• Hoarseness of voice;
• Inflammation of the trachea and larynx.

Infectious disease specialists distinguish 2 forms of croup – true and false. The first form develops due to damage to the vocal cords. The only nosology in which true croup occurs is diphtheria infection.

False croup contains all stenotic non-diphtheria laryngitis.

Regardless of its form, acute airway obstruction is a pathology that requires urgent treatment. Symptoms should be identified early, and decongestants and bronchodilators should be administered as early as possible.

Treatment of childhood laryngospasm

If laryngospasm occurs, its treatment is aimed not at eliminating the condition itself, but at eliminating the factors that provoked the development of the disease. They can be determined by an otolaryngologist after conducting a series of studies.

Experts recommend a number of manipulations as a treatment for childhood laryngospasm. Effective assistance during an attack can be achieved by inhaling ammonia vapor by the child. In addition, anticonvulsant drugs are introduced into the child’s body, for example, through an enema containing chloral hydrate (the dose of the substance is 0.5 g per 200 ml of water). For prolonged spasms, warm baths have a good effect. In the morning and evening, it is recommended to take a solution of potassium bromide (0.5%).

Treatment methods

By taking therapeutic measures in a timely manner, it will be possible to reduce the likelihood of deterioration in health. Spasms of various origins can be eliminated using several methods, including drug treatment, folk remedies and surgery. The treatment procedure is aimed at combating etiological factors; therefore, therapy is carried out for the underlying disease that provoked the development of laryngospasm.

Medicines and drugs

A common treatment for childhood laryngospasm is medication. The drug most often used to combat seizures is Dexamethasone, which is approved for use from an early age. The drug is administered intramuscularly or intravenously.

Before taking medications to relieve laryngospasm, you should consult your doctor. The doctor will check your health status, identify possible contraindications and prescribe the appropriate dosage. In addition, medications are dispensed in pharmacies only with an appropriate prescription. In addition to the drug, the action of which is aimed at eliminating the causative agents of spasms, there are drugs that relieve swelling of the throat and internal irritation.

Medicines that relax the muscles of the larynx help get rid of painful symptoms and prevent negative consequences.

Physiotherapy

Physiotherapeutic procedures are not used separately as a therapeutic method to combat attacks.

Physiotherapy is used as an adjunct to comprehensive treatment along with medications or surgery.

The list of standard physiotherapeutic procedures includes:

• hardening with cold water;
• daily performance of a set of sports exercises at home;
• ultraviolet irradiation using specialized equipment in an outpatient setting.

Inhalations

To eliminate the effects of laryngospasm and relieve pain, inhalation procedures are also prescribed. To carry them out, a special nebulizer is used, which allows you to start treatment even at home. Steam procedures can be performed using mineral liquid, saline solution or medications.

Since attacks of laryngospasm do not occur once, patients at risk are advised to keep a nebulizer at home and prepare an inhalation composition in advance. Timely implementation of the procedure helps alleviate the painful condition and improve the child’s well-being.

Surgery

If taking medications in combination with other procedures does not lead to the expected result, or more effective measures are required to treat laryngospasm, the need for surgical intervention arises. To combat childhood laryngospasm, two operations are performed - tracheal intubation and tracheotomy.

Tracheal intubation is carried out by organizing air flow through a thin tube. Through it, oxygen penetrates into the lungs and stabilizes the patient’s breathing. The tracheotomy procedure is performed only when the patient is hospitalized. Under anesthesia, the trachea is surgically cut to provide oxygen.

After medical intervention, periodic examination and testing are required. To adjust the further treatment plan, the doctor needs to take a current picture of your health status.

Prerequisites for the development of the disease in adults

The development of laryngospasm in adults can be provoked by various diseases affecting the gallbladder, larynx, pharynx, trachea, and an attack also occurs as a consequence of chorea, spasmophilia, bronchopneumonia. The prerequisites for the development of the disease in adults may be different, but it is always worth looking for the primary factor that triggers pathological changes.

Along with the listed diseases, the causes of laryngospasm can be:

• penetration of irritants from the air into the respiratory tract;
• inflammation in the larynx;
• allergic reaction to a number of drugs;
• stressful situations;
• hysteria.

In addition, contractions are caused by increased sensitivity to a certain drug introduced into the body through the nasal cavity.

Features of treatment

Depending on what symptoms and treatment is selected, the appropriate one is selected, since initially it is necessary to eliminate the factors that provoked the occurrence of the pathological process. It happens that an attack occurs after the penetration of foreign objects into the larynx area, and therefore, in order to alleviate the patient’s condition, they must be removed. At the same time, it is necessary to carry out appropriate treatment, which is why it is important to call an ambulance in a timely manner.

An attack of laryngospasm can be triggered by too dry air. That is why laryngospasm can be relieved using a nebulizer. Inhalations can be carried out with mineral water or saline solution. In addition, inhalations are also carried out using special medications, but they should only be prescribed by the attending doctor.

If the patient experiences asphyxia, then an urgent need to perform an indirect cardiac massage and perform artificial respiration. Unlike adults, children are required to be hospitalized for several days to observe and identify the cause of laryngospasm.

Symptoms of laryngospasm in adults

Often, the occurrence of muscle spasms in the larynx in adults occurs against the background of a weakened immune defense of the body, as a result of which it becomes vulnerable to the effects of a variety of infectious diseases.

Specific symptoms of laryngospasm in adults, which is a consequence of hysteria, are simultaneous convulsions of the limbs, esophagus and pharynx. The development of such symptoms is possible when a mirror is inserted into the throat to examine the larynx, but these contractions are short-lived.

Most often, a laryngospasm attack is accompanied by:

• wide mouth opening;
• difficulty breathing with whistling;
• the appearance of cold sweat;
• increased tension in the neck muscles;
• pallor of the skin of the face.

Symptoms

The very first manifestation of progressive laryngospasm is noisy and quite difficult inhalation. Against the background of this symptom, cyanosis of the skin forms (especially in the lip area), due to which the neck muscles become tense.

Symptoms during attacks:

• The patient's mouth is constantly open quite wide.
• There is increased sweating.
• The pulse appears thread-like in nature.
• Due to the rapid increase in carbon dioxide levels in the body, the respiratory center is irritated, and the respiratory function itself comes to a stable state.

When laryngospasm becomes severe, the following symptoms are added in addition to the main clinical picture:

• Fainting.
• Convulsive syndrome spreading throughout the entire muscular skeleton.
• There is a discharge of foam from the mouth.
• The Patient may experience involuntary bowel and bladder emptying.
• Cessation of cardiac activity.

Laryngospasm in adults is quite specific. Hysterical laryngospasm is characterized by its simultaneous occurrence with convulsions of the pharynx, esophagus, and limbs. In patients with hysteria and other neuroses, laryngospasm may manifest itself when a laryngeal speculum is inserted into the pharynx, but such an attack quickly passes by itself.

Sometimes the attack is similar to epilepsy. In less serious cases, laryngospasm may be limited to a short-term narrowing of the glottis, prolonged inhalation with a characteristic whistle, pale or blue discoloration, noisy inhalation, or short-term shortness of breath, sobbing.

Laryngospasm can occur in conjunction with tracheospasm, when the smooth muscles of the posterior membranous part of the trachea simultaneously contract.

Laryngospasm poses the greatest danger due to possible death from asphyxia if the attack continues for too long. It is for this reason that it is necessary to have an idea of ​​​​the complex of measures to provide emergency care for laryngospasm.

First aid for laryngospasm in adults

Primary first aid measures for laryngospasm in adults are as follows:

• place the person on a hard, flat surface;
• facilitate air access to the lungs by unbuttoning the top layer of clothing;
• ensure the supply of fresh air to the room where the patient is located (ventilate the room);
• eliminate external irritants, create absolute silence;
• stop the attack by sprinkling the patient’s face with water, inducing a gag reflex;
• call an ambulance.

Ambulance specialists will provide assistance to the victim, which will include:

• administration of intravenous injection with calcium gluconate;
• the use of tracheotomy or intubation if all previous measures are ineffective;
• performing indirect cardiac massage when it stops;
• carrying out oxygen therapy.

First aid

If the patient has an attack, it is important to provide him with emergency assistance in a timely manner. The first thing to do is to calm the person down, not to let him rush around and panic, as these actions only aggravate his condition.

First aid for laryngospasm in adults and children:

• provide the patient with fresh air. For this purpose, he is taken out of the room to the street or all the windows in the room are opened;
• If possible, give him water to drink;
• Spray your face with water;
• use of stimuli. You can pinch the patient, tickle him.

An attack of laryngospasm in adults can be eliminated by asking the patient not to breathe for as long as possible. During this time, carbon dioxide will accumulate in the body, irritating the respiratory center. Emergency assistance is also supplemented by:

• administration of anticonvulsants;
• in difficult cases, the patient is immersed in a warm bath;
• in case of fainting, it is recommended to inhale vapors of ammonia.

When the first symptoms appear, you should immediately call an ambulance.

Treatment of laryngospasm in adults

Therapeutic measures to eliminate the symptoms of laryngospasm in adults are no different from those used in children. Treatment should be aimed at eliminating those factors that were the source of the development of the disease. In case of attacks due to severe stress, anxiety and other neurological factors, the patient must be provided with rest.

If the cause of laryngospasm is a lack of elements such as calcium and vitamin D, adjustments to the diet and diet are required. Just as in children and adults, in situations with frequent attacks, it is good to use warm baths and a solution of potassium bromide in oral doses. It is important to remember that treatment of laryngospasm in adults and children is prescribed by a doctor on an individual basis. An excellent way to counteract attacks is inhalation using mineral water or medications prescribed by the doctor.

Just like children, adults also need to be prescribed calcium supplements, attend physiotherapeutic procedures (ultraviolet irradiation), harden the body and take long walks in the fresh air. In addition, you should consume more milk products and fresh vegetables.

Reasons for appearance

Pathology can be observed not only in childhood, but also in adults. The difference in the course of the disease is that in a child, swelling of the larynx due to muscle contractions occurs many times faster.

In the area of ​​the larynx there are soft and sensitive tissues in which increased blood circulation occurs.

It is difficult to single out one cause of attacks of laryngospasm, since several can cause an attack at once, including the following:

• disturbances in the functioning of the hormonal system;
• metabolic changes;
• the presence of diseases caused by pathologies of the trachea and nasopharynx;
• spasmophilia.

In adults

The results of multiple studies have helped to identify the causes of laryngospasm that are unique to adults.

Such reasons include:

• changes in the body's reactivity;
• a sharp increase in the excitability of the reflex neuromuscular apparatus of the larynx;
• improper metabolism in the body;
• significant lack of calcium salts and vitamin D;
• psychological trauma.

In children

The child may suffer from the effects of laryngospasm as a result of exposure to an allergic reaction. Allergies that occur due to the penetration of toxic substances or dust particles contained in the air lead to the risk of swelling of the larynx. As a result, natural breathing is disrupted, and the toxin entering the throat causes a spasm. With age, the body's susceptibility to toxic substances decreases, so this reason is relevant for children.

Prevention of laryngospasm

Preventive measures constitute one of the stages of treatment of laryngospasm in children and adults. They are often recommended to be performed continuously, even in the absence or weakening of attacks. Prevention measures are very simple. One of the main provisions is a long stay in the fresh air.

In order to prevent laryngospasm in children, it is recommended to perform special exercises to help the child relax, special games, attending a massage, and drawing together with the child. But it should be remembered that the baby should perform all actions at ease.

In addition, to prevent illness, it is necessary to follow a balanced diet, enriched with vitamins, and be sure to increase the amount of dairy products consumed.

Diagnostics

Diagnosis consists of assessing the patient’s clinical picture and the data of his objective examination during auscultation and percussion. Differential diagnosis is carried out with diphtheria, foreign bodies of the larynx, Quincke's edema.

Radiography for laryngospasm makes sense only if the presence of a foreign body is suspected; in other cases, this procedure will not show the necessary result.

A blood test is not informative, since croup in children is caused by viral diseases, the only manifestation of which may be an increase in lymphocytes or ESR. You can take a blood test for serological diagnostics and determine the virus that caused laryngospasm using ELISA, but this is a long and expensive procedure. If quick relief of symptoms is necessary, this test is not performed.