Paradoxical Vocal Motion or Vocal Cord Dysfunction

Vocal cord dysfunction is the abnormal closure of the vocal cords, which causes sudden, severe attacks of breathing difficulty. It can occur in patients of any age, although it is most common in young, healthy females. It can occur in combination with asthma or may exist alone. It is probably a reflex mechanism that the voice box uses to protect the lungs, involuntarily closing the vocal cords when exposed to any irritants. 


The following can trigger a VCD attack: 

  • Strong scents 
  • Smoke
  • Breathing cold air 
  • Breathing through the mouth
  • Laughing 
  • Coughing 
  • Vigorous exercise 
  • Drinking very cold liquids 

Try to avoid these triggers until the VCD is under control. 

Most common associated conditions: 

  • Asthma 
  • Reactive airway disease or “exercise-induced” asthma 
  • Gastroesophageal reflux disease 
  • Allergic rhinitis 


Signs and symptoms: 

  • Difficulty moving air in or out of lungs 
  • Sensation of “air being cut off” or “throat closing off” 
  • Wheezing or squeaky sounds from the throat not the lungs 
  • Voice changes: can vary from hoarseness to aphonia (inability to speak) 
  • Tightness or discomfort in the throat or neck 
  • “Lump in the throat” sensation 
  • Cough 


Treatment involves: 

  • Avoiding triggers of VCD 
  • Treating any underlying disorders (asthma, GERD, allergies) 
  • Exercises to promote vocal cord relaxation 

Treatment of underlying disorders: 

  • Controlling asthma with preventative and rescue inhalers 
  • Avoiding exercise-induced VCD by starting to exercise slowly, with “warm-ups” and using nasal inhale, oral exhale breathing
  • Controlling any acid reflux with medication 
  • If you don’t have symptoms of acid reflux, you may have “silent reflux,” or laryngeal reflux; it is very important that you take the medication prescribed by your doctor 
  • Avoiding acid stimulants like caffeine, alcohol, tobacco, spicy foods, chocolate, and eating before exercising or before going to bed at night 
  • Controlling allergy symptoms with prescription or OTC medications

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