ACUTE SPASMODIC LARYNGITIS

 

ACUTE SPASMODIC LARYNGITIS

 

DEFINITION:

Acute spasm of the larynx characterized by the sudden onset of cough and inspiratory stridor.

EPIDEMIOLOGY:

  • incidence: ?
  • age of onset:
    • between 1-3 years of age (stridor)
  • risk factors:
    • see below

PATHOGENESIS:

1. Background

  • major pathophysiologic process is acute spasm of the larynx
  • also referred to as spasmodic croup

2. Etiology

  • 1. Infectious
    • viral
  • 2. Allergic
  • 3. Psychological
    • may be seen more frequently in anxious or excitable children
    • may be a familial predisposition
  • CLINICAL FEATURES:

    1. Prodrome

    • usually preceded by mild-to-moderate coryza and hoarseness

    2. Respiratory Manifestations

    • croupy cough and inspiratory stridor:
      • sudden onset usually at night during sleep
      • episodes tend to be brief (hours) and occur over 2-3 nights
      • tends to recur throughout year
      • symptoms less severe than in infectious croup
      • patients appear well after an episode except for slight hoarseness and cough

    3. Complications

    • upper airway obstruction:
      • may range from mild inspiratory and expiratory stridor to severe respiratory distress

    INVESTIGATIONS:

    1. Direct Laryngoscopy

    • usually normal

    2. Throat Culture

    • swab for C & S

    MANAGEMENT:

    1. Supportive

    • respiratory support with severe or life-threatening upper air-way obstruction, i.e., intubation, tracheostomy

    2. Breaking of Laryngeal Spasm

    • episode may be broken by humidified air (cold or warm) used either acutely or over 2-3 days until the cough has subsided
    • may also break episode by inducing vomiting, i.e., 1 tbsp. of ipecac

     

    Pediatric Database - ACUTE SPASMODIC LARYNGITIS

    Pediatric Organization - Pedbase [at] Gmail.com