Paradoxical vocal fold movement (PVFM), happens when the vocal folds close instead of open. For example, when taking a deep breath, the vocal folds should open to let air through to the lungs. With PVFM, the vocal folds will close, making it hard to breathe. Often misdiagnosed as asthma, PVFM most often causes wheezing, stridor, and breathing problems.

Triggers of PVFM include:

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


Every person with PVFM may have different problems at different times, making it hard to initially diagnose. Your care team 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. They may also test your voice and look at how you use it to see if you have any other voice problems.


Voice Therapy: A speech-language pathologist (SLP) can help with voice therapy focused on breathing re-training. You may learn voice and breathing exercises and ways to relax and manage your symptoms when you start to have breathing trouble.