Adductor Respiratory Laryngeal Dystonia (Dystonic Respiratory Stridor): Clinical Characterization and Response to Botulinum Toxin Therapy: A Single Centre Experience.

BACKGROUND

Adductor respiratory laryngeal dystonia (ARLD) is a rare focal dystonia with vocal fold closure during inspiration leading to stridor and dyspnoea.

OBJECTIVES

To characterize clinical features and outcomes of patients with ARLD at a tertiary movement disorders center.

METHODS

A retrospective cohort study was conducted of patients with adductor respiratory laryngeal dystonia attending a botulinum toxin injection clinic.

RESULTS

Nineteen patients were identified. Most were female (94.7%). Mean age of onset was 51.9 years (range 39-89). Comorbid movement disorders included laryngeal dystonia, cervical dystonia, blepharospasm, dystonic tremor, and Parkinson's disease. Median time from symptom onset to diagnosis was 3.0 years (IQR 2.0-15.0). 92.8% of injections with botulinum toxin were effective, although 46.2% were associated with adverse events.

CONCLUSIONS

ARLD is associated with diagnostic delay. Symptoms of stridor alongside other movement disorders may provide clues. Treatment with botulinum toxin is effective, though careful dosing is required.