Myasthenic inspiratory vocal cord dysfunction: Efficacy of nasal continuous positive airway pressure treatment

Myasthenic vocal cord dysfunction (VCD), presenting with severe inspiratory strider, was successfully treated with nasal continuous positive airway pr essure (nCPAP), thus giving the medical staff time to make the diagnosis an d avoiding intubation or tracheostomy. An important sign leading to diagnos is was the very high MEF50/MIF50 ratio calculated from the flow-volume loop , nCPAP treatment induced prompt remission of strider and a sharp reduction in the MEF50/MIF50 ratio from 9.90 to 1.36. A review of the literature has shown that VCD with inspiratory strider is an unusual onset symptom of mya sthenia gravis and that nCPAP treatment may avoid emergency oral/tracheal i ntubation and tracheostomy. After diagnosis, the patient underwent thymecto my, and today, 3 years later, he is well without any further therapy, Copyr ight (C) 2000 S. Karger AG, Basel.