Paradoxical vocal cord motion disorder - An unexpected mimicker of bronchial asthma

Abstract

Paradoxical vocal cord motion (PVCM) disorder, otherwise called vocal cord dysfunction is a very peculiar disorder often misdiagnosed and mistreatment. The awareness of such a condition is very little between practicing pulmonologist and otolaryngologist and often patients are treated as bronchial asthma or get tracheostomized misdiagnosed as bilateral abductor cord palsy. We present a case of a 25-year-old lady, who was being treated for bronchial asthma in the form of oral and inhaled steroids. She presented to the emergency with a supposed acute exacerbation of asthma. However, the patient did not respond to intravenous and nebulized steroids. The patient was referred to the otolaryngologist and fiber optic laryngoscopy was done and a diagnosis of bilateral abductor cord palsy. The patient was subsequently tracheostomized and decannulated once the vocal cord motion recovered. However, the patient again presented to the emergency with stridor, but this time a detailed fibreoptic laryngoscopy helped us to diagnose PVCM disorder. The patient was treated with nothing other than psychotherapy and speech therapy and the patient recovered never to get a further episode. We discuss the important aspects of clinical features, diagnosis, and management of this unique condition.