{
  "abstract": "Background Adductor respiratory laryngeal dystonia (ARLD) is a rarer, less studied manifestation of laryngeal dystonia. It can occur in tandem with spasmodic dysphonia or in isolation. In ARLD, laryngeal muscles close involuntarily during respiratory inspiration, resulting in stridor and dyspnoea. We characterise ARLD in a large, consecutive cohort of patients who attend the botulinum toxin clinic at St Vincent’s Hospital Sydney.Methods A retrospective case series and analysis of patients attending the specialist Botulinum Toxin clinic at St Vincent’s Hospital Sydney, a tertiary referral centre. All patients with active records were reviewed and relevant data collected.Results Of 509 patient files 19 patients were identified with adductor respiratory laryngeal dystonia.18(94.7%) were female. Ages ranged from 39 to 88, with a mean of 65.9 years. Mean time from symptom onset to diagnosis was 9.0 years. All patients had concurrent spasmodic dysphonia, and 11(57.9%) had comorbid movement disorders including cervical dystonia, blepharospasm, dystonic tremor and Parkinson’s Disease. 8(42.1%) patients reported attacks triggered by smoke, dust, perfume, eating, drinking or exercise. 18(94.7%) patients opted for botulinum toxin treatment with bilateral electromyography (EMG) guided injections into the thyroarytenoid muscles, which is effective and well tolerated.Conclusion ARLD is a rare and challenging neurological condition, that may present to respiratory physicians or emergency departments with acute respiratory distress. Stridor with spasmodic dysphonia or other movement disorders should raise clinical suspicion. Triggerable attacks with environmental irritants represent another important clue. Treatment with percutaneous botulinum toxin to bilateral thyroarytenoid muscles represents an effective and well-tolerated therapeutic option.",
  "authors": [
    {
      "affiliations": [
        "Neurology, St George Hospital, Sydney, NSW, Australia"
      ],
      "name": "Owen Chan"
    },
    {
      "affiliations": [
        "Neurology, St Vincent’s Hospital Sydney, Sydney, NSW, Australia"
      ],
      "name": "Isabelle Osborne"
    },
    {
      "affiliations": [
        "Neurology, St Vincent’s Hospital Sydney, Sydney, NSW, Australia"
      ],
      "name": "Samuel Bolitho"
    },
    {
      "affiliations": [
        "Neurology, St Vincent’s Hospital Sydney, Sydney, NSW, Australia"
      ],
      "name": "Stephen Tisch"
    }
  ],
  "title": "CS14 Adductor respiratory laryngeal dystonia (dystonic respiratory stridor): clinical characterisation and response to botulinum toxin therapy – a single centre experience",
  "uid": "6bb91f1c-b59e-5579-8e39-79a19558fe34"
}