Paradoxical vocal cord motion: A review focused on multiple system atrophy

An abnormality of the laryngeal output-feedback control underlies nonorganic PVCM, which is usually triggered by an excessive response to external and internal airway stimuli. Similarly, several clinical and experimental evidence suggest that MSA-related PVCM is attributed to the airway reflex as well as to paradoxical central outputs resulting from the MSA-induced damage to the pontomedullary respiratory center. Application of continuous positive airway pressure (CPAP), which suppresses the reflexive inspiratory activation of adductors, is recommended as the treatment for MSA-related PVCM.