Pseudoasthma in a case of asthma.
The respiratory system, which is composed of the upper and lower airways performs varied and distinct functions. These can also be the sites of various pathological processes. Asthma is one of the major conditions involving the lower airways whereas laryngeal dysfunction due to various conditions has also been known to occur. Isolated laryngeal dysfunction with abnormal vocal cord movements has been shown to occur both in various organic and non-organic conditions. The non-organic laryngeal dysfunction with a functional component is being increasingly recognized, the symptoms of which can be easily confused with those of asthma. We describe a patient who is believed to have both asthma and functional laryngeal dysfunction with paradoxical motion of the vocal cords on inspiration, observed on direct laryngoscopy. It is also believed that her laryngeal dysfunction is an isolated clinical entity not related to her underlying asthma, which has been shown, at times, to be associated with non-compensatory adduction of the vocal cords on inspiration. The patient described is known to have an anxious and hysterical personality and was also diagnosed to have a major depression. Episodes of paradoxical motion of the vocal cords on inspiration are acute and are usually precipitated by an emotional event and the shortness of breath may or may not be associated with stridor. Treatment of this condition, which can be mistaken for asthma, involves speech/vocal cord exercises to be used at the advent of an attack. It is thus important to recognize this condition so that appropriate treatment can be given.(ABSTRACT TRUNCATED AT 250 WORDS)
Division of Rheumatology, Allergy and Clinical Immunology, University of California Davis, School of Medicine, USA.
A P
AP
Imam
G M
GM
Halpern
D000328:Adult; D001249:Asthma / Q000150:complications* / Q000503:physiopathology; D001980:Bronchi / Q000503:physiopathology; D005260:Female; D006801:Humans; D007830:Larynx / Q000503:physiopathology