Paradoxical Vocal Fold Movement (PVFM)

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PVFM makes it hard to breathe or talk. It does not happen all of the time but can cause serious problems when it does happen. Speech-language pathologists, or SLPs, can help.

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About PVFM

Paradoxical vocal fold movement, or PVFM, happens when your vocal folds close when they should open. For example, when you take a breath, your vocal folds should open to let air through to your lungs. With PVFM, your vocal folds will close, making it hard to breathe. You will not have any other problems with your vocal folds except when PVFM happens.

Signs of PVFM

PVFM can cause wheezing and breathing problems. Some people may need to go to the hospital when they cannot breathe. People with PVFM may be told that they have asthma. But, PVFM is not asthma. It is a problem with how and when the vocal folds move.

Causes of PVFM

Causes of PVFM include:

  • shouting or coughing
  • exercise
  • acid reflux
  • breathing cold air
  • smoke or pollen
  • emotional or psychological issues
  • neurological issues

Testing for PVFM

You may see a team of professionals to find out if you have PVFM. They include a:

  • speech-language pathologist
  • neurologist
  • pulmonologist
  • otolaryngologist, or ear, nose, and throat doctor
  • psychologist

Every person with PVFM will have different problems at different times. This makes it hard to know if you have PVFM or some other problem. The team will go over your medical history. They will ask about the medicines you take and if you smoke.

The SLP or doctor can look at your vocal folds through a tube that goes into your mouth or nose, called an endoscope. A flashing light, called a stroboscope, lets the team watch your vocal folds move. The SLP may also test your voice and look at how you use it to see if you have any other voice problems.

Treatments for PVFM

You may need medical treatment for PVFM if you have allergies or reflux. You may need to see a psychologist if you feel stressed or have emotional problems that cause PVFM.

An SLP can help with voice therapy. You may learn voice exercises and ways to relax when you start to have breathing trouble. The goal of treatment is to make you aware of what triggers PVFM. You can then try to avoid those triggers. You can also learn how to handle an episode when it happens.

See ASHA information for professionals on the Practice Portal's Voice Disorders page.

To find a speech-language pathologist near you, visit ProFind.