VCD is a non-organic disorder in which the larynx and/or supraglottic structures move in a paradoxic manner, thus disrupting the normal flow of air into the lungs.
VCD presents as respiratory difficulty with either inspiratory stridor resembling acute upper airway obstruction or wheezing suggestive of asthma. Patients describe chocking, tightness in the upper chest and throat, coughing, suffocation, difficulty “getting air in”, and occasionally dizziness, light-headedness, headaches and/or tingling and numbness of the hands or feet.
Unlike asthma, VCD episodes typically have rapid onset and equally rapid resolution without sequellae. Severity of symptoms may fluctuate during a given episode or intensify when attention is focused on it. Many patients will experience episodes only during exercise.
Asthma is often present with VCD and can confuse the clinical picture. There are other conditions which can predispose to, provoke or intensify VCD. These include nasal allergies, sinusitis, postnasal drip, gastroesophageal reflux, and history of airway manipulation (surgeries, endotracheal intubations, ventilation, etc.).
Speech Pathology is the cornerstone of treatment for VCD. Two to five sessions with a trained therapist are usually required for a patient to feel confident in the techniques and these must be practiced during asymptomatic periods to insure success during the episodes.
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