Primary laryngospasm in a patient with Parkinson's disease: Treatment with CPAP via minitracheostomy following intubation

Abstract

Building on data published by M C Vos and colleagues in 1992 on imipenem/cilastatin and CAVHD [1] we in vestigated imipenem/cilastatin in 16 pa tients with (n = 10, group 1) and without in = 6, group 2) renal insufficiency; both

Recurrent choking in Parkinson’s disease

“…Although many of these patients had normal vocal cord studies when awake, virtually all demonstrated paradoxical cord movements, or even paralysis, when sleep was induced with benzodiazepines. EMG studies have illustrated that it is dystonia, not paralysis which causes the stridor in these cases 3. Such diurnal variation parallels that seen in our case of Parkinson’s disease, with normal vocal cord movement early in the day and paradoxical movements becoming apparent in the late evening.…”

“…Although stridor and severe respiratory compromise are well-recognised complications of another synucleinopathy, multiple system atrophy,1, 2 it has seldom been reported in idiopathic Parkinson’s disease 3 – 5. By contrast, in multiple system atrophy, both focal laryngeal dystonia and vocal cord paresis have been implicated in the development of stridor 6, 7.…”

“…Although continuous positive airway pressure (CPAP) ventilation2 and even botulinum toxin injection3 have been used in the treatment of such symptoms in multiple system atrophy, we decided on tracheostomy due to the frequency and severity of the attacks. This treatment has been used with good success in many patients with multiple system atrophy in the past, and resulted in complete resolution of symptoms and a reduction in daytime somnolence in our patient.…”

Mini Tracheostomy for Obstructive Sleep Apnea: An Evidence Based Proposal

“…Of the ninety-five published studies, six [46–51] report the use in patients with acute upper airway obstructions, one [19] describes the use in two patients with upper airway obstructions (it did not specify if it was for an acute process), and none describes the use of mini tracheostomies for obstructive sleep apnea; see Figure 1. The MTK tracheostomy tubes are small-bore cannulas and have an internal diameter of 4 mm, an outer diameter of 5.4 mm, and a length of 90 mm.…”

Deep Brain Stimulation—Surgery for Movement Disorders and Parkinson's Disease

“…Primary laryngospasm is a known complication of PD and acute withdrawal of treatment can cause airway obstruction. 13 Dentition is often impaired. Patients who have been receiving dilantin may have gum hypertrophy and loosening of teeth that may hamper placement of an airway.…”