Vocal cord dysfunction masquerading as bronchial asthma.

Vocal cord dysfunction (VCD) is a relatively rare condition that may mimic asthma or upper airway obstruction. In contrast to initial reports, recent work emphasizes that patients with VCD often may have both asthma and VCD concurrently. VCD presents a formidable diagnostic challenge. Spirometry often gives variable results. The diagnosis is confirmed at direct laryngoscopy by observing abnormal vocal cord movements without other pathologic processes. Therapy of VCD involves removal of unnecessary medications, efforts to minimize vocal cord irritation, and aggressive speech therapy. In selected cases, anxiolytic medications and psychiatric consultation may be beneficial.