BACKGROUND Anti-N-methyl-D-aspartate receptor(anti-NMDAR)encephalitis is a rare autoimmune disorder.The symptoms of anti-NMDAR encephalitis include behavioral problems,speech problems,psychosis,seizures,and memory def...BACKGROUND Anti-N-methyl-D-aspartate receptor(anti-NMDAR)encephalitis is a rare autoimmune disorder.The symptoms of anti-NMDAR encephalitis include behavioral problems,speech problems,psychosis,seizures,and memory deficits,among others.However,laryngospasm is rare.We present the case of a patient with anti-NMDAR antibodies and severe laryngospasms.CASE SUMMARY The patient was a 15-year-old female with normal psychomotor development.She was initially admitted to our neurological intensive care unit with seizures.She received anti-epilepsy treatment,and the seizures disappeared.However,2 wk later,she developed behavioral problems and speech impairment.Then,she developed severe laryngospasms,which were treated with intubation and a tracheotomy.Antibodies against the NMDAR were detected in the patient’s cerebrospinal fluid.Therefore,she was diagnosed with anti-NMDAR encephalitis.In addition,she received intravenously administered immunoglobulins,and methylprednisolone was administered.The patient’s symptoms gradually improved,and she was discharged from our hospital.Approximately 9 mo later,the patient could speak sentences,walk independently,and carry out activities of daily living independently.Through our case report,we highlighted laryngospasm as an uncommon presentation in patients with anti-NMDAR encephalitis.CONCLUSION Laryngospasm may be an uncommon clinical manifestation of anti-NMDAR encephalitis.展开更多
THE incidence of gastroesophageal reflux disease （GERD） is high in Western nations. Its extraesophageal manifestations such as asthma, paroxysmal laryngospasm, and excessive throat phlegm,
目的研究反流性喉痉挛(gastroesophageal reflux laryngospasm,GERL)的临床特点及其对综合诊治的反应。方法纳入2010年1月至2016年6月连续住院,症状问卷调查符合喉痉挛发作特点,胃镜、测压及24 h pH检查后行PPI、食管贲门射频治疗或胃...目的研究反流性喉痉挛(gastroesophageal reflux laryngospasm,GERL)的临床特点及其对综合诊治的反应。方法纳入2010年1月至2016年6月连续住院,症状问卷调查符合喉痉挛发作特点,胃镜、测压及24 h pH检查后行PPI、食管贲门射频治疗或胃底折叠术后喉痉挛症状消失,随访观察12个月以上喉痉挛无发作而诊断为GERL的患者,统计分析GERL患者的gastroesophageal reflux disease(GERD)症状谱,喉痉挛发作特点、检查结果及对抗反流治疗的反应。结果本研究共纳入GERL患者64例,平均年龄48.9岁。71.9%患者伴有反酸、烧心等典型GERD症状,75%的患者伴有咳嗽、哮喘等食管外症状。35.9%患者主诉反酸可致呛咳,继而出现喉痉挛,73.4%的患者自觉餐后、进食刺激性食物、饱食或饮酒后喉痉挛多发,42.2%的患者喉痉挛多发于平卧睡眠中。24 h pH监测和胃镜检查的病理性酸反流和食管炎的检出率分别为53.1%和48.6%。本组有37.5%的患者对PPI的反应良好,51.6%有部分反应,10.9%对PPI反应不佳;84.4%的患者因不能停用PPI或PPI疗效不佳选择食管贲门射频治疗或胃底折叠术,取得了良好的疗效。结论喉痉挛可作为GERD的食管外表现之一。GERL患者可合并GERD的典型症状和/或食管外症状,部分患者可自觉喉痉挛发作与反流症状、饮食、体位等因素相关而有助于GERL的诊断。GERL通常对PPI、射频治疗和胃底折叠术等抗反流治疗反应良好。展开更多
Asthma is a disorder of the lungs characterized by increased responsiveness of the airways,as manifested by episodes of wheezing and increased resistance to expiratory airflow because of varying degrees of smooth musc...Asthma is a disorder of the lungs characterized by increased responsiveness of the airways,as manifested by episodes of wheezing and increased resistance to expiratory airflow because of varying degrees of smooth muscle contraction,edema of the mucosa,and mucus in the lumen of the bronchi and bronchioles.The stimuli vary widely and include antigens,infection,air pollutants,respiratory tract irritants,exercise,and emotional factors.This condition is completely different from distress breathing because of laryngotracheal spasm.One of its causes is the gastric content reflux through the pharynx to the larynx because of gastroesophageal reflux disease(GERD),in addition to the typical human avian flu that may cause immediate suffocation by laryngospasm owing to acute larygotrachitis.A patient suffered from GERD without esophageal symptoms,which was diagnosed and treated as bronchial asthma during his five emergency admissions.The admissions were because of episodic attacks of severe air hunger owing to an extreme throat tightening.The patient was being treated for as long as two years.After the correct diagnosis was made and treatment of laporascopic fundaplication was performed,the longstanding“bronchial asthma”,after all,completely disappeared.The concept of“not asthma,but GERD”seems undervalued,unappreciated,even misunderstood among patients with intractable asthma.Therefore,such a case is reported in detail,similar cases are mentioned briefly as well,and a mechanism responsible for GERD-originated larryngo-or laryngotracho-spasm is proposed.展开更多
文摘BACKGROUND Anti-N-methyl-D-aspartate receptor(anti-NMDAR)encephalitis is a rare autoimmune disorder.The symptoms of anti-NMDAR encephalitis include behavioral problems,speech problems,psychosis,seizures,and memory deficits,among others.However,laryngospasm is rare.We present the case of a patient with anti-NMDAR antibodies and severe laryngospasms.CASE SUMMARY The patient was a 15-year-old female with normal psychomotor development.She was initially admitted to our neurological intensive care unit with seizures.She received anti-epilepsy treatment,and the seizures disappeared.However,2 wk later,she developed behavioral problems and speech impairment.Then,she developed severe laryngospasms,which were treated with intubation and a tracheotomy.Antibodies against the NMDAR were detected in the patient’s cerebrospinal fluid.Therefore,she was diagnosed with anti-NMDAR encephalitis.In addition,she received intravenously administered immunoglobulins,and methylprednisolone was administered.The patient’s symptoms gradually improved,and she was discharged from our hospital.Approximately 9 mo later,the patient could speak sentences,walk independently,and carry out activities of daily living independently.Through our case report,we highlighted laryngospasm as an uncommon presentation in patients with anti-NMDAR encephalitis.CONCLUSION Laryngospasm may be an uncommon clinical manifestation of anti-NMDAR encephalitis.
文摘THE incidence of gastroesophageal reflux disease （GERD） is high in Western nations. Its extraesophageal manifestations such as asthma, paroxysmal laryngospasm, and excessive throat phlegm,
文摘目的研究反流性喉痉挛(gastroesophageal reflux laryngospasm,GERL)的临床特点及其对综合诊治的反应。方法纳入2010年1月至2016年6月连续住院,症状问卷调查符合喉痉挛发作特点,胃镜、测压及24 h pH检查后行PPI、食管贲门射频治疗或胃底折叠术后喉痉挛症状消失,随访观察12个月以上喉痉挛无发作而诊断为GERL的患者,统计分析GERL患者的gastroesophageal reflux disease(GERD)症状谱,喉痉挛发作特点、检查结果及对抗反流治疗的反应。结果本研究共纳入GERL患者64例,平均年龄48.9岁。71.9%患者伴有反酸、烧心等典型GERD症状,75%的患者伴有咳嗽、哮喘等食管外症状。35.9%患者主诉反酸可致呛咳,继而出现喉痉挛,73.4%的患者自觉餐后、进食刺激性食物、饱食或饮酒后喉痉挛多发,42.2%的患者喉痉挛多发于平卧睡眠中。24 h pH监测和胃镜检查的病理性酸反流和食管炎的检出率分别为53.1%和48.6%。本组有37.5%的患者对PPI的反应良好,51.6%有部分反应,10.9%对PPI反应不佳;84.4%的患者因不能停用PPI或PPI疗效不佳选择食管贲门射频治疗或胃底折叠术,取得了良好的疗效。结论喉痉挛可作为GERD的食管外表现之一。GERL患者可合并GERD的典型症状和/或食管外症状,部分患者可自觉喉痉挛发作与反流症状、饮食、体位等因素相关而有助于GERL的诊断。GERL通常对PPI、射频治疗和胃底折叠术等抗反流治疗反应良好。
文摘Asthma is a disorder of the lungs characterized by increased responsiveness of the airways,as manifested by episodes of wheezing and increased resistance to expiratory airflow because of varying degrees of smooth muscle contraction,edema of the mucosa,and mucus in the lumen of the bronchi and bronchioles.The stimuli vary widely and include antigens,infection,air pollutants,respiratory tract irritants,exercise,and emotional factors.This condition is completely different from distress breathing because of laryngotracheal spasm.One of its causes is the gastric content reflux through the pharynx to the larynx because of gastroesophageal reflux disease(GERD),in addition to the typical human avian flu that may cause immediate suffocation by laryngospasm owing to acute larygotrachitis.A patient suffered from GERD without esophageal symptoms,which was diagnosed and treated as bronchial asthma during his five emergency admissions.The admissions were because of episodic attacks of severe air hunger owing to an extreme throat tightening.The patient was being treated for as long as two years.After the correct diagnosis was made and treatment of laporascopic fundaplication was performed,the longstanding“bronchial asthma”,after all,completely disappeared.The concept of“not asthma,but GERD”seems undervalued,unappreciated,even misunderstood among patients with intractable asthma.Therefore,such a case is reported in detail,similar cases are mentioned briefly as well,and a mechanism responsible for GERD-originated larryngo-or laryngotracho-spasm is proposed.
