We present a variant of Munchausen's syndrome not previously described
in which acute severe asthma is the presenting complaint. The clinica
l presentation is so extreme that the patient htrs received artificial
ventilation on several nl occasions despite having had normal arteria
l blood gas values. The patient appears to be able to mimic the signs
of severe respiratory distress by means of a protracted Valsalva manoe
uvre, and all signs of acute asthma instantaneously disappear with sed
ation. Because of the chronic 'asthma', and the frequent dramatic acut
e episodes, the patient successfully claims invalidity benefit, and ha
s done so for many years.