Laryngospasm: Causes, symptoms, and treatments
While a mild laryngospasm where you can still exhale air can be frightening, it is usually not dangerous, and typically lasts only a few minutes.
A spasm in the vocal cords can be an isolated incident and be caused by a variety of medical conditions.
Normally, the vocal cords separate when a person breathes, which is called abduction. A laryngospasm causes the vocal cords to be forcibly pushed together, called adduction. When the vocal cords spasm, they can fully or partially close the airway.
- During a laryngospasm, most people can still cough and exhale air but may struggle to take in air.
- A laryngospasm feels similar to choking. This is because, similarly to choking, the airway is blocked.
- Remaining calm and holding the breath for 5 seconds may treat it, along with other techniques.
- People should contact a doctor after experiencing a laryngospasm since another may occur.
- If you are not able to breathe or if you hear a high-pitched wheezing sound called stridor when you breathe, then you need emergency medical help.
What is a laryngospasm?
Tightness in the throat may be a symptom of laryngospasm.
The spasm typically lasts about 60 seconds, which is not long enough to pose any danger. Rarely, particularly, as a reaction to anesthesia, a laryngospasm lasts longer and needs emergency medical attention.
These spasms can happen when people are eating, but unlike choking, nothing is lodged in the throat. Other symptoms of laryngospasm include:
- sudden difficulty breathing with no obvious cause
- a feeling of tightness in the throat
- occasionally, loss of consciousness
Because a laryngospasm is often the product of another condition, there may be other symptoms. People with gastroesophageal reflux disease (GERD), for instance, may experience symptoms of heartburn or reflux immediately before, during, or after a spasm in the vocal cords.
Sometimes a more serious condition can resemble a laryngospasm. People who experience difficulty breathing associated with a new medication or food should not assume the problem is a laryngospasm. In these cases, tightness in the throat could signal an allergic reaction.
What causes a laryngospasm?
A laryngospasm may be a reflex to prevent accidental drowning.
Doctors think that a laryngospasm may be a reflex designed to prevent accidental drowning or suffocation.
People who accidentally inhale food while talking, for example, can benefit from a laryngospasm because it prevents the food from blocking the airway. This is the reason why it is common to experience a laryngospasm while eating or drinking. Some people experience symptoms after feeling as if food has gone down "the wrong pipe."
Unlike choking, a person experiencing a laryngospasm will not feel something physically lodged in the throat. The Heimlich maneuver also does not stop a laryngospasm.
Eating is just one potential laryngospasm cause. Some alternative causes for this frightening sensation include:
Stress and anxiety
Some people may experience a laryngospasm in response to intense anxiety or stress. During a panic attack, hyperventilation or intense fear may trigger a laryngospasm. The tightness in the throat can then make the panic even worse.
Anesthesia can trigger the laryngospasm reflex, particularly in children. It is even more common in babies. Overall, about 1 percent of adults and children, receiving anesthesia, experience a laryngospasm. In children who have asthma or a respiratory infection, the incidence increases to about 10 percent.
People who experience a laryngospasm under general anesthesia for surgery might never know it happened since the anesthesiologist will immediately intervene.
Neurological issues can trigger a laryngospasm. For instance, people who have recently sustained a spinal cord or brain injury may experience muscle spasms, including laryngospasm.
Nerve injuries, particularly in or near the neck and spine, can also be a factor. Some people with paralyzed vocal cords experience laryngospasms.
Gastroesophageal reflux disease (GERD)
Gastroesophageal reflux disease (GERD) is a syndrome that causes the stomach contents, including stomach acid, to flow back up the esophagus and into the throat.
Some people with GERD experience intense burning and pain. Some individuals also experience laryngospasm. A small study of eight people with GERD found that a recent respiratory infection increases the risk of laryngospasm. In this group, forceful coughing triggered both laryngospasms and fainting.
Asthma and allergies
People with asthma and respiratory allergies are more vulnerable to laryngospasm. Treating these allergies and carrying an asthma inhaler can reduce the risk of future spasms. People with respiratory issues, including asthma, are more vulnerable to laryngospasm while under anesthesia.
Treatments for laryngospasm
Holding the breath for 5 seconds, in through the nose and out through pursed lips, may stop a laryngospasm.
During a laryngospasm, a person should always try to remain calm. They should not gasp for air or try to gulp air in through their mouth. Panicking can make the spasm last longer and will cause symptoms to feel more intense.
A few simple techniques may stop the spasm:
- Hold the breath for 5 seconds, then breathe slowly through the nose. Exhale through pursed lips. Repeat until the spasm stops.
- Cut a straw in half. During an attack, seal the lips around the straw and breathe in only through the straw and not the nose. This technique encourages slower breathing that can help relax the vocal cords.
- Push on a pressure point near the ears. This point, known as the laryngospasm notch, can force the vocal cords to relax. Locate the soft spot behind the earlobes and just above the jaw. Forcefully push down and in toward the throat. The pressure should be forceful enough to be painful, and if it works, it should relieve the symptoms of laryngospasm immediately.
Other treatments focus on addressing the underlying cause of laryngospasms. For instance, people with anxiety disorders may benefit from anti-anxiety medications or psychotherapy. Treating ulcers can reduce the severity of GERD, potentially stopping laryngospasms, as well.
People who have frequent laryngospasms at night may need to sleep with a continuous positive airway pressure (CPAP) machine. Speech therapy may help in some cases, particularly when there is a neurological cause. When other treatments fail, a botulinum toxin (Botox) injection can paralyze the vocal cords and prevent subsequent attacks.
When to see a doctor about laryngospasm
Doctors can perform a battery of tests to determine the cause. They will also ask questions about lifestyle, anxiety, and the conditions surrounding the spasm. Gastrointestinal testing, a CT scan of the sinuses, allergy testing, and trials of various medications can help illuminate the cause.
People who have a history of laryngospasm should tell their doctor about their experience before undergoing anesthesia. Although extremely rare, if a laryngospasm does not stop after a minute or two, or if it causes a loss of consciousness, it should be treated as a medical emergency. Call 911 or go to the emergency room.