Parakinesis of Vocal Cords as a Cause of Dyspnea

Overview

Parakinesis of vocal cords is presently a rare disease in the area of laryngology andphoniatrics. It becomes manifest as a spastic occlusion of first two thirds of glottis, either ininspiration, expiration or in both phases of respiration and is accompanied with stridor. Thesimultaneous paradox movements of vocal cords may affect phonation, when the vocal cords are inabduction position and the conditions results in aphonia. The disease, which is by farmore frequentin the shape of inspiration spasm of vocal cords, has been observed by pneumologists and allergologists,who refer to the defect as dysfunction of vocal cords. It is most frequently encountered incorticoid-resistant asthmatic patients and not infrequently simulates asthma. Parakinesis andsimilar conditions are also observed is some psychiatric diagnoses. Typical for these patients is thatthe difficulties disappear during sleep. In order to exclude somatic causes it is possible to classifythe disease into somatoform dysfunctions. The therapeutic strategy is based in early psychotherapyand rehabilitation of breathing, supportive pharmacological therapy, while intubation should beexceptional in conjunction with another form of dyspnoe as well as tracheotomy, provided it wasindicated at all, should be replaced by temporary laterofixation.

Key words:
dyspnoe, parakinesis of vocal cords, inspiration spasm of vocal cords, vocal cordsdysfunction .