Paradoxical vocal cord adduction mimicking as acute asthma in a pediatric patient

We report an adolescent girl with paradoxical vocal cord adduction who pres ented with acute onset of hyperventilation, wheezing and strider that did n ot respond to bronchodilator and anti-inflammation therapy. The paradoxical vocal cord motion was confirmed by flexible fiberoptic bronchoscopic exami nation. We found the strider was induced by hyperventilation, and was cause d by paradoxical vocal cord movement. The abnormal cord motion may be psych ogenic and could be misdiagnosed as asthma. It is important to investigate the underlying background and social history and to avoid unnecessary use o f beta-agonists, steroids, and even endotracheal intubation or tracheostomy .