Paradoxical Vocal Fold Movement
Paradoxical Vocal Fold Movement (PVFM) is a condition characterized by occasional attacks of breathing difficulty in which one’s vocal folds involuntarily adduct during inhalation and/or exhalation, and therefore restrict the airflow to and from the lungs (Mathers-Schmidt, 2001). It is also referred to as Vocal Cord Dysfunction and although it is not necessarily a voice disorder, voice disorders often co-occur with it. This paper will look to explore factors influencing the differential diagnosis of PVFM, treatment options, and the role of a Speech-Language Pathologist in working with patients with this diagnosis.
PVFM is likely to occur more frequently in adults than children and in females than males at a ratio of 3:1 (Patel, Venediktov, …show more content…
There are many different proposed etiologies to the diagnosis of PVFM, but no single cause has yet to be empirically established. PVFM occurs as the result of a threat to the upper respiratory tract (Mathers-Schmidt, 2001). It’s possible etiologies include psychological, upper airway sensitivities from laryngeal irritants, neurological origins, or as the manifestation of an underlying laryngeal dystonia.
Psychological factors play a role in the etiology of PVFM, because patients with emotional problems such as stress, anxiety, or depression may exacerbate the problems associated with PVFM. Conversely, it is also possible that depression and anxiety are consequences of rather than causes of persistent respiratory problems. Literature suggests difficulty drawing firm conclusions regarding the psychological etiologies of PVFM, as only a subgroup of patients with PVFM have revealed emotional conflicts or psychiatric disturbances (Mathers-Schmidt, …show more content…
Relevant information to obtain includes questioning the patient about the onset of his or her symptoms along with any co-occurring events or illnesses, finding out the duration each episode may last, or any triggers they may experience prior to an episode. The Speech-Language Pathologist may also want to question if the patient feels any tightness or pain and the location of such issues if present, if he or she is noticing a concurrent cough, or lightheadedness. Perceptual symptoms to listen for and question the presence of include hoarseness, aphonia, a sense of effort upon inhalation or exhalation, stridor, wheezing, and stridor (Reitz, Gorman, & Kegyes,
PVFM is likely to occur more frequently in adults than children and in females than males at a ratio of 3:1 (Patel, Venediktov, …show more content…
There are many different proposed etiologies to the diagnosis of PVFM, but no single cause has yet to be empirically established. PVFM occurs as the result of a threat to the upper respiratory tract (Mathers-Schmidt, 2001). It’s possible etiologies include psychological, upper airway sensitivities from laryngeal irritants, neurological origins, or as the manifestation of an underlying laryngeal dystonia.
Psychological factors play a role in the etiology of PVFM, because patients with emotional problems such as stress, anxiety, or depression may exacerbate the problems associated with PVFM. Conversely, it is also possible that depression and anxiety are consequences of rather than causes of persistent respiratory problems. Literature suggests difficulty drawing firm conclusions regarding the psychological etiologies of PVFM, as only a subgroup of patients with PVFM have revealed emotional conflicts or psychiatric disturbances (Mathers-Schmidt, …show more content…
Relevant information to obtain includes questioning the patient about the onset of his or her symptoms along with any co-occurring events or illnesses, finding out the duration each episode may last, or any triggers they may experience prior to an episode. The Speech-Language Pathologist may also want to question if the patient feels any tightness or pain and the location of such issues if present, if he or she is noticing a concurrent cough, or lightheadedness. Perceptual symptoms to listen for and question the presence of include hoarseness, aphonia, a sense of effort upon inhalation or exhalation, stridor, wheezing, and stridor (Reitz, Gorman, & Kegyes,