Postneuroleptic laryngeal dyskinesias: a cause of upper airway obstructive syndrome improved by local injections of botulinum toxin.
We report a case of laryngeal dyskinesia resulting in severe rest and exercise dyspnea. A 51-year-old man treated for 2 years with flupentixol, an incisive neuroleptic, developed severe dyspnea due to intermittent, rhythmic, and dystonic movements of the vocal cords and upper airway. Local injections of botulinum toxin resulted in spectacular regression of laryngeal spasms and major improvement in breathing. This case emphasizes the risk of upper respiratory dyskinesias associated with neuroleptic treatment and shows the feasibility of a new local treatment in this life-threatening disorder.
Fève
A
A
Service de neurologie, Hôpital Tenon, Paris, France.
Angelard
B
B
Fénelon
G
G
Logak
M
M
Guillard
A
A
Lacau Saint-Guily
J
J
D000402:Airway Obstruction / Q000139:chemically induced / Q000188:drug therapy; D001905:Botulinum Toxins / Q000008:administration & dosage*; D004409:Dyskinesia, Drug-Induced / Q000188:drug therapy*; D004576:Electromyography / Q000187:drug effects; D005475:Flupenthixol / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007273:Injections, Intramuscular; D007818:Laryngeal Diseases / Q000139:chemically induced* / Q000188:drug therapy; D007821:Laryngeal Muscles / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000187:drug effects; D013179:Spouse Abuse / Q000517:prevention & control*; D014754:Violence
D001905:Botulinum Toxins; D005475:Flupenthixol