Paroxysmal vocal cord movement/motion (PVCM), paroxysmal
vocal cord dysfunction (PVCD), episodic paroxysmal
laryngospasm (EPL), and irritable larynx syndrome (ILS) are terms used to describe laryngeal dysfunction masquerading as
asthma, upper
airway obstruction, or functional and organic
voice disorders. The differential diagnosis of PVCM, PVCD, EPL, and ILS is critical to successful medical and behavioral management of the patient. During the past 10 years, 27 subjects, ages 15-79 years, were identified to have paroxysms of inspiratory
stridor, acute respiratory distress, associated
aphonia and
dysphonia, resulting in misdiagnosis and unnecessary
emergency treatments, including endotracheal intubation,
cardiopulmonary resuscitation, massive
pharmacotherapy, or
tracheostomy. A multifactorial management program is proposed utilizing principles of motor learning, neurolinguistic programming model, respiratory and phonatory synchronization,
relaxation techniques, concurrent monitoring of behavioral adjustments, and formal psychological counseling.