EPISODIC LARYNGEAL DYSKINESIA - A REPORT OF 3 PEDIATRIC CASES WITH A REVIEW OF THE LITERATURE

Three pediatric cases of episodic laryngeal dyskinesia are reported, i n three girls, aged 14, 15, and 16 years. One patient was referred for intractable asthma despite appropriate therapy with an inhaled cortic osteroid, a one-acting beta2-agonist, and long-acting theophylline: an other for a six-month history of recurrent cough; and the third for a two-year history of recurrent laryngeal dyspnea mistakenly ascribed to laryngitis. Physical exertion was the main precipitating factor in tw o patients. The symptoms were severe; one patient was admitted to a pe diatric emergency department six times over a one-year period. In two cases, the inspiratory segment of the flow-volume curves showed a cren elated appearance. Laryngeal videoendoscopy contributed to the diagnos is in all three cases. A peculiar psychological profile was evidenced. There was no evidence of asthma, the patient under chronic anti-asthm a therapy was able to discontinue all her drugs, and had no asthma sym ptoms six months after initiation of speech therapy and psychotherapy. A similar outcome was noted in another patient, in whom follow-up is now three years. Fewer than 30 cases of intermittent laryngeal dyskine sia have been reported in children. Cases in children and adolescents are usually isolated whereas asthma is present in half the cases in ad ults. The diagnosis rests on careful analysis of the symptoms and flow -volume curves, and on laryngeal videoendoscopy during an attack.