[Stress-inducible functional laryngospasm: differential diagnostic considerations for bronchial asthma]

Since 1974 about 30 cases of functional upper airway obstruction are known in literature. We report the findings in a 19 year old woman, who was free from any symptoms during rest. During exercise (swimming, jogging) she showed a loud inspiratory stridor, cyanosis, and dyspnoea. We found this stridor was induced by exercise or hyperventilation only (thread mill, CO2 rebreathing), and was caused by paradoxical vocal cord movement (fibreoptic laryngoscopy in local anaesthesia during CO2 rebreathing). All lung function parameters improved after inhalation of ipratropium bromide. We believe that it is important to investigate these patients during stridor attacks and without general anaesthesia. Otherwise it will be impossible, to get a correct diagnosis.