Paradoxical Vocal Fold Movement (PVFM) is best described as?

• A. Episodic breathing difficulties due to abnormal adduction of VFs on inhalation.
• B. Chronic cough with wheeze.
• C. Lower airway obstruction during exhalation only.
• D. Involvement of the epiglottis rather than vocal folds.

Answer: (A)

PVFM happens when the vocal folds move in the opposite way they should during breathing: they come together (adduct) during inhalation, narrowing the airway. This inspiratory obstruction causes episodic breathing difficulty, sometimes with stridor or wheeze, and is often mistaken for asthma. The key point is that the problem occurs on inhalation due to abnormal adduction of the vocal folds, not during exhalation or involving the epiglottis. That’s why describing episodic breathing difficulty caused by abnormal adduction of the vocal folds on inhalation best fits PVFM.