Journal article
Hemi-laryngopharyngeal Spasm (HeLPS): Defining a New Clinical Entity
Annals of otology, rhinology & laryngology, v 129(9), pp 849-855
01 Sep 2020
PMID: 32312092
Abstract
Objective:
Hemi-laryngopharyngeal spasm (HeLPS) has recently been described in the neurosurgical literature as a cause of intermittent laryngopharyngeal spasm and cough due to vascular compression of the vagus nerve at the cerebellopontine angle. We present the diagnostic criteria for this syndrome.
Methods:
A retrospective chart review of six patients with HeLPS and three patients misdiagnosed with this condition are presented. All patients were diagnosed and treated at a tertiary care academic centre from July 2013 to July 2017.
Results:
Patients with HeLPS had five defining characteristics: 1) All patients had symptoms of episodic laryngopharyngeal spasm and coughing. Patients were asymptomatic between episodes and were refractory to speech therapy and reflux management. 2) Laryngoscopy showed hyperactive twitching of the ipsilateral vocal fold in two of the six patients. No other inter-episodic abnormalities were seen. 3) Botulinum toxin A injections into the thyroarytenoid muscle on the affected ipsilateral side reduced laryngopharyngeal spasms. Botulinum toxin injection in the contralateral thyroarytenoid muscle did not improve laryngopharyngeal spasm. 4) Magnetic resonance imaging revealed ipsilateral neurovascular compression of the vagus nerve rootlets by the posterior inferior cerebellar artery. 5) Microvascular decompression (MVD) surgery of the ipsilateral vagus nerve resolved all symptoms (follow-up 2-4 years).
Conclusion:
The diagnostic criteria for hemi-laryngopharyngeal spasm (HeLPS) are proposed. Otolaryngology recognition of this new clinical entity may lead to a surgical cure and avoid the unnecessary therapies associated with misdiagnosis.
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Details
- Title
- Hemi-laryngopharyngeal Spasm (HeLPS): Defining a New Clinical Entity
- Creators
- Amanda Hu - University of British ColumbiaMurray Morrison - University of British ColumbiaChristopher R. Honey - University of British Columbia
- Publication Details
- Annals of otology, rhinology & laryngology, v 129(9), pp 849-855
- Publisher
- Sage
- Number of pages
- 7
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Otolaryngology (and Head and Neck Surgery)
- Web of Science ID
- WOS:000527755700001
- Scopus ID
- 2-s2.0-85083799362
- Other Identifier
- 991019298821404721
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Otorhinolaryngology