Gluteal cramp

Of the Gluteal cramp is a spasm that prevents the aspiration of fluids with sustained contractions of the muscles located there. A glottic cramp is usually caused by inhaled water droplets and is particularly dangerous for water sports enthusiasts. The administration of muscle relaxants stops the spasm.

What is a glottic cramp?

The glottis is also known in medicine as the glottis. These are the vocal fold apparatus, the glottis and the associated cartilage structures. At the Gluteal cramp the glottis and larynx cramp up.

This phenomenon is also called Laryngospasm or Glottic spasm known and is a protective mechanism which in and of itself has no pathological value. Instead of being associated with disease, glottic spasm prevents fluids from entering the nearby windpipe. Even if you are unconscious, the spasm does not automatically resolve.

As long as the muscles in the area of ​​the glottis are contracting, the windpipe is, so to speak, closed and thus safe from the entry of any substances. In anesthesia, however, the automatic and involuntary protective mechanism is one of the most devastating complications. The negative pressure that a glottic spasm can trigger is also clinically relevant. This negative pressure can promote the formation of edema.

causes

In most cases, glottis is caused by inhaled drops of water. Therefore, the phenomenon often occurs especially in water sports or diving. Since breathing stops with glottic cramps, those affected often panic and even pass out in the process. This is a dreaded complication in diving.

Since the spasm does not always resolve after fainting, divers with glottis often suffocate as a result of the spasm. This type of drowning from persistent airway blockage is also called dry drowning. The cause of drowning, however, is not the spasm of the glottis itself.

The triggering cause of the spasm cannot be eliminated under water by the actually intended cough reflex. This connection only triggers the spasm of the glottic muscles. Irrespective of water sports, glottis spasms sometimes occur during the induction or discharge of anesthesia, since manipulation and excitation of the airways is registered during intubation or extubation.

Symptoms, ailments & signs

The glottis is a spasm. Those affected experience an involuntarily induced, long-lasting and strongly pronounced contraction of the glottic muscles. A spasm is often associated with more or less severe pain caused by the unusually violent contractions in the muscles.

Glottic spasm is not a clonic, but a tonic spasm. So the contraction is relatively static and constant. It usually lasts at a constant strength for a long time. During the persistent spasm, patients stop breathing and panic. The more panicked they get, the faster they lose consciousness. In the case of a spasm, a negative pressure relationship arises, which can promote accompanying symptomatic edema.

This water retention can cause swelling within a very short time. If edema develops, the glottic spasm can develop into a life-threatening condition. This is especially true when the upper respiratory tract is involved, where any edema affects breathing and therefore requires immediate intervention.

Diagnosis & course of disease

The diagnosis of glottis spasm is made by the emergency doctor, if at all. In most cases, the context of the triggering situation and the visual diagnosis provide sufficient information for a diagnosis. After the diagnosis and initial treatment of the patient by the emergency doctor, the patient must be brought to the hospital.

This is important to rule out the formation of edema in the upper airways. Glottic cramps in themselves have a favorable prognosis. Exceptions are those that take place under or in the water and cause those affected to pass out.

Complications

The violent contractions that occur with glottic cramp can cause various symptoms as the disease progresses. The pain is usually severe, causing problems with swallowing and breathing. If edema develops, glottis spasms can cause life-threatening complications.

The impaired breathing then leads to shortness of breath, shortness of breath or aspiration. Those affected usually panic and hyperventilate, which ultimately leads to a loss of consciousness. If the spasm is not treated by then at the latest, the person concerned threatens to suffocate. Emergency medical care also carries risks. Positive pressure ventilation can create pressure points or cause the airways to dry out.

If unsuitable hoses are used, this can lead to eye irritation. The concomitantly administered drug succinylcholine can cause cardiovascular problems, muscle pain and intraocular pressure disorders. In addition, allergic reactions may occur or the patient may experience interactions such as cardiac arrhythmias or gastrointestinal complaints due to another illness.

Further complications can arise if the patient takes other medications regularly or is very weak physically. The administration of drugs must then be monitored by a doctor in any case.

When should you go to the doctor?

If drops of water are accidentally swallowed during water sports activities or swimming in a swimming pool or leisure pool, this normally does not pose any further problems. There is a brief shortage of breath that usually regulates itself automatically within a few seconds. A doctor's visit is not necessary in these cases. Due to the natural cough reflex, misdirected portions of the liquid are directed to the right places or transported out of the mouth again.

However, if the ingested fluid causes a cramp or a disturbance of consciousness, action is required. If you experience pain or unusual contractions in the neck area, see a doctor. Anxiety or panic conditions should also be discussed with a therapist or doctor. If there is swelling, changes in the voice, or persistent nausea, it is advisable to have further tests carried out. A clarification of the cause is necessary in order to be able to bring about changes in the long term. The formation of edema and other swellings in the airways can trigger a life-threatening condition. Therefore, in the event of breathlessness or shortness of breath, consult a doctor.

A tightness in the throat is a sign of a health problem and needs further investigation. In the event of a loss of consciousness, an emergency service must be alerted immediately. People present are requested to take first aid measures.

Treatment & Therapy

One of the first steps in emergency medical treatment for a glottic cramp is positive pressure ventilation through a mask. In mild cases, this measure not only solves the spasm, but also prevents the development of edema. In many cases, after this measure, there is no need for any further therapy for the spasm symptoms, since the spasm has resolved itself and the triggering cause has long been eliminated.

Depending on the strength of the spasm and the intensity of the triggering cause, the onset of fainting triggers the contractions and breathing starts again. Since the unconsciousness does not necessarily have to lead to the resolution of the symptoms of cramps, further treatment may be necessary in individual cases. The treatment is usually carried out by giving muscle relaxants.

The administration of succinylcholine, for example, releases the cramp in seconds. However, since these drugs also affect the respiratory muscles, the patient must be intubated when administered. In this case, artificial respiration takes place until the muscle relanxacia lose their effect. If edema develops despite all measures, this edema must be resolved in the hospital. This resolution is usually medicated but requires medical supervision if the upper respiratory tract is involved.

You can find your medication here

prevention

The glottic cramp can be prevented. Water sports enthusiasts in particular should take measures to avoid aspirating water droplets. Glottic cramps during anesthesia must be prevented by anesthetists by avoiding excessive irritation of the airways during extubation and intubation. As a complication in anesthesia, glottic cramps have become rather rare due to the now tightened preventive measures.

Aftercare

Follow-up care for a glottic cramp depends on the cause and the course. Usually, the glottic cramp goes away on its own. Depending on the trigger, the patient often needs medical assistance. The glottic cramp usually occurs only once. After the cause has been identified and the patient has been discharged, no further follow-up examinations are usually necessary.

If the pain persists, medication is prescribed as part of the treatment. These must be removed carefully. This is usually monitored by the responsible doctor to avoid complications. If edema has formed, surgery is necessary. The patient then has to spend a few days in the hospital for follow-up care.

If there are pressure points during the emergency medical care, the affected area must be carefully monitored as part of the follow-up care. Otherwise the airways can dry out and cause further discomfort. In the case of cardiovascular complaints or disorders of the intraocular pressure, as can occur due to incorrect emergency medical treatment, further monitoring in a clinic is necessary.

Follow-up care for a glottic cramp is carried out by the emergency doctor and the general practitioner. Depending on the cause, other specialists such as an ENT doctor or an internist can be called in. If the glottis is caused by motor disorders, physiotherapeutic treatment may also be useful.

You can do that yourself

When practicing water sports, the person affected should practice using water well in advance. The interaction of water and physical sports activities must be practiced so that there is no situation of health impairment. For this, it is particularly important to reflect on your own skills. Overestimating yourself can lead to disorders or illnesses.

Instead, the use of aids or adequate protection of the airways is advisable. There are various items on the market that block the penetration of water into the airways in contact with water during sporting activities. They were specially developed for this purpose and are often used by athletes of all stripes. The person concerned should try out whether he is better positioned with such utensils and ignore visual discomfort.

If there are health problems, you should always keep calm. Help has to be called and hectic movements are to be avoided. These can lead to an increase in symptoms and trigger a life-threatening condition. It is therefore helpful in everyday life to make prior arrangements with people from the social environment who are in the immediate vicinity of the sporting activities. Hand signals can be agreed so that we can react immediately if necessary. Particularly when dealing with children, warning signals should be adequately explained beforehand.