laryngism

Laryngospasm - suddenly arising attacks of convulsive spasm of the muscles of the larynx, causing narrowing or complete closure of the glottis.

At the heart of laryngospasm is increased excitability of the neuromuscular apparatus of the larynx. Observed mainly in children on artificial feeding, changing the reactivity of the organism, metabolic disorders, lack of in the body of calcium and of vitamin D, against the background of pneumonia, rickets, chorea, spazmofilii, hydrocephalus, trauma, post-partum trauma, and others. For laryngospasm can cause breathing air containing irritants (dust, etc.), lubrication of the mucous membrane of the larynx certain medications, the irritation of the vagus and recurrent laryngeal nerve (goiter, tumor, aneurysm), excitement. There is also in hysteria, eclampsia, tetanus, tabes dorsalis. Children may develop during crying, coughing, laughing, when frightened, choking.

Laryngospasm in children is manifested by a sudden loud whistling labored breath, pallor or cyanosis of the persons included in the act of respiration auxiliary muscles, tension of the neck muscles. During the attack the baby's head is usually thrown back, mouth wide open, marked a cold sweat, thready pulse , a temporary stop breathing. Then, due to the accumulation of carbon dioxide in the body, and irritation of the respiratory center breathing is restored. In mild cases, the attack lasted a few seconds, resulting in an extended breath, then the child begins to breathe deeply and rhythmically, sometimes falling asleep briefly. Seizures can be repeated several times a day, usually in the afternoon. In severe cases, when the attack lasts longer, may be generalized convulsions , foaming at the mouth, loss of consciousness, involuntary urination and defecation, cardiac arrest. In protracted attack can lead to death from asphyxia.

Hysterical laryngospasm in adult patients with combined seizures of the pharynx, the esophagus, the limbs; attack quickly terminated independently. Sometimes an attack reminiscent of an epileptic seizure. In mild cases, it may be limited to short-term narrowing of the glottis, the protracted nature of breath wheezing, pallor or bluish face, noisy breath or shortness of breath short, sobbing.

Treatment. During the attack should be to reassure the patient, provide fresh air, give water to drink, spray your face with cold water, give oxygen, apply irritating (pinch the skin, pat on the back, pull the language, and others.). Laryngospasm can be removed, offering the patient the best possible long hold your breath, followed by a normal breath, or cause a gag reflex dotragivanii spatula, spoon until the tongue. Recommend also sniffing fumes of ammonia, the introduction of anticonvulsants (chloral hydrate enema - 0.3 - 0.5 g per 1 cup of water), and in cases of long - warm baths, into 0.5% potassium bromide solution of 1 teaspoon spoon 2 times a day (for children doses these drugs depend on the age). Very rarely resort to tracheal intubation or tracheostomy. In all cases, repeated laryngospasm should consult a doctor. Showing restorative therapy, and hardening. Assign calcium supplements, vitamin D, ultraviolet irradiation, a rational mode of the long stay in the open air, mostly dairy-vegetarian food.

Most favorable prognosis. Children laryngospasm usually disappears with age.