TREATMENT OF ADDUCTOR LARYNGEAL BREATHING DYSTONIA WITH BOTULINUM TOXIN TYPE-A

Adductor laryngeal breathing dystonia (ALBD) is a rare disorder in whi ch patients have persistent inspiratory strider, usually normal voice, and cough. Physical exam is characterized by paradoxical movement of the vocal cords on inspiration. These patients have involuntary action -induced spasms of the adductor laryngeal muscles on inspiration. Ther e has been no uniformly satisfactory treatment for the disease. Speech therapy, psychotherapy, and pharmacotherapy have all had limited succ ess. We report the successful use of botulinum toxin type A in seven p atients with adductor laryngeal breathing dystonia. All patients recei ved bilateral thyroarytenoid injections. All patients had toxin effect within 72 hours, reaching maximal effect within 2 weeks with sustaine d improvement for an average of 13.8 weeks. Adverse effects included b reathy voice and mild choking on liquids. Both resolved, on average, w ithin 2 weeks. This retrospective study supports the safe and effectiv e use of botulinum toxin type A in the treatment of adductor laryngeal breathing dystonia,