Thirty- five consecutive adult patients with paroxysmal laryngospasm (LS) an d with unimpaired vocal fold mobility were prospectively studied for coexisting gastroesophageal reflux disease (GERD). Nineteen patients reported frequent (>3 episodes a week) LS episodes (FLS patients) and 16 patients reported occasional LS episodes (OLS patients). All patients underwent an extensive otorhinolaryngol ogical (ORL) examination, upper gastrointestinal (GI) endoscopy, ambulatory 24- hr dual- channel esophageal pH monitoring, and esophageal manometry. In additi on, a subset of LS patients also underwent ambulatory duodenogastroesophageal re flux (DGER) monitoring. Patients with daily LS used the symptom marker during pH monitoring indicating separate LS episodes. All FLS patients and 14 OLS patient s (87% ) had a diagnosis of GERD. Only 10 patients (29% ) experienced heartbur n and/or regurgitation. Compared to OLS patients, FLS patients generally had mor e severe GERD as indicated by a higher prevalence of a hiatus hernia, higher dis tal and proximal esophageal acid exposure times, and higher values of DGER. In s ix FLS patients, 21 LS episodes(91% ) occurred simultaneously with acid reflux, indicating a causal association between LS and GER. On antireflux therapy consi sting of omeprazole, 20 mg bid, or lansoprazole, 30 mg oid, and lifestyle measur es, LS ceased completely in all patients within 6 weeks. The present study not o nly demonstrates the role of GER in the pathogenesis of LS and the effectiveness of antireflux therapy, but also suggests that LS in adult patients with unimpai red vocal fold mobility might be considered a typical, although most frequently unrecognized, supraesophageal manifestation of GER. Thirty-five consecutive adult patients with paroxysmal laryngospasm (LS) an d with unimpaired vocal fold mobility were prospectively studied for coexisting gastroesophageal reflux disease (GERD). Nineteen patients reported frequent (> 3 episodes a week) LS episodes (FLS patients) and 16 All patients underwent an extensive otorhinolaryngol ogical (ORL) examination, upper gastrointestinal (GI) endoscopy, ambulatory 24-hr dual-channel esophageal pH monitoring, and esophageal manometry. In additi on, a subset of LS patients also underwent ambulatory duodenogastroesophageal re flux (DGER) monitoring. Patients with daily LS used the symptom marker during pH monitoring showed separate LS episodes. All FLS patients and 14 OLS patient s (87%) had a diagnosis of GERD. Only 10 Compared to OLS patients, FLS patients generally had mor e severe GERD as indicated by a higher pr evalence of a hiatus hernia, higher dis tal and proximal esophageal acid exposure times, and higher values ​​of DGER. In s ix FLS patients, 21 LS episodes (91%) occurred simultaneously with acid reflux, indicating a causal association between LS and GER. On antireflux therapy consi sting of omeprazole, 20 mg bid, or lansoprazole, 30 mg oid, and lifestyle measur es, LS ceased completely in all patients within 6 weeks. The present study not o nly demonstrates the role of GER in the pathogenesis of LS and the effectiveness of antireflux therapy, but also suggests that LS in adult patients with unimpai red vocal fold mobility might be considered a typical, although most frequently unrecognized, supraesophageal manifestation of GER.