Chest
Clinical InvestigationsEpisodic Laryngeal Dyskinesia: Clinical and Psychiatric Characterization
Section snippets
Subjects
Over a ten-month period, we performed outpatient examinations of eight adult subjects with loud wheezes which appeared to originate in the neck area. The patients were identified from a pool of 1,098 new patients seen with obstructive airway disease. Seventy-three percent of these patients were referred by employers or by industrial commission and could potentially benefit from workman's compensation. The eight patients had been frequently examined in emergency rooms or admitted to hospitals
RESULTS
We studied three men and two women with episodic laryngeal dyskinesia. All were nonsmokers with a duration of symptoms ranging from three to 24 years (Table 1). Four of them had been exposed to steroid therapy during many of their very symptomatic periods. Their ages ranged from 48 to 74 years. The four who were cooperative showed no expiratory airways obstruction (Table 2). Characteristically, these patients presented to the initial and subsequent evaluations with inspiratory and expiratory
DISCUSSION
Patients with episodic laryngeal dyskinesia may be identified clinically by noting an increased tightness of the anterior neck muscles, local fremitus and a wheeze of variable pitch best heard over the anterior neck in inspiration and expiration. They are characterized physiologically by the absence of significant expiratory obstruction, diminished inspiratory flow rates, and fluttering of the inspiratory limb in flow-volume loop studies. Even in mildly symptomatic ambulatory patients,
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Cited by (64)
Inductible laryngeal obstruction
2023, Revue Francaise d'AllergologieVocal Cord Dysfunction
2013, Immunology and Allergy Clinics of North AmericaCitation Excerpt :In addition to the 3 terms already mentioned, VCD believed to be primarily caused by a psychological component has been referred to as emotional laryngeal wheezing,12 psychogenic upper airway obstruction,13 and psychogenic stridor.14 Over the past several decades, the recognition that VCD can occur outside psychological illness has shifted the medical literature toward more general terms such as pseudoasthma,15 nonorganic upper airway obstruction,16 functional upper airway obstruction,17 factitious asthma,18 spasmodic croup,19 episodic laryngeal dyskinesia,20 functional laryngeal obstruction,21 functional laryngeal stridor,22 episodic paroxysmal laryngospasm,23 irritable larynx syndrome (ILS),24 and paradoxic vocal fold motion (PVFM).25 Of these terms, the most common are VCD, which is most often used by pulmonologists, allergists, and mental health practitioners, and PVFM, more popular among otolaryngologists and speech-language pathologists.5
Respiratory problems in neurologic movement disorders
2010, Parkinsonism and Related DisordersCitation Excerpt :Anxiolytics may be also helpful. If these measures are not sufficient, intermittent continuous positive airway pressure (CPAP) usually reverses the glottic narrowing [84]. CPAP is considered the first choice of treatment for MSA related stridor, as it is relatively non-invasive and has been reported to improve not only the stridor, but also the function of the hypopharynx and vocal cords [67,78,85,86].
Diagnostic criteria for the classification of vocal cord dysfunction
2010, ChestCitation Excerpt :Stressors, including combat and competitive sports, are noted more frequently as a VCD trigger.29–31 Depression has been a common underlying psychiatric diagnosis in many patients with VCD; large studies evaluating psychiatric disorders noted similar findings, with 33% to 40% of patients with VCD with major depression.13,32 There is likewise a higher reported of abuse (including sexual) in patients with VCD.23,26,32–34
Vocal Cord Dysfunction, Paradoxic Vocal Fold Motion, or Laryngomalacia? Our Understanding Requires an Interdisciplinary Approach
2010, Otolaryngologic Clinics of North AmericaCitation Excerpt :Major depression or dysthymia was present in 13% of VCD patients in the review by Lacy and McManis.53 Other large studies evaluating psychiatric disorders reported similar findings, with 33% to 40% of VCD patients having major depression.54,61 In addition to psychological counseling, the use of antidepressants may be indicated to control VCD symptoms.
Psychiatric Aspects of Respiratory Symptoms
2008, Pediatric Respiratory Medicine
Manuscript received February 10; revision accepted Mar 22.