OBJECTIVES: (1) To present a rare case of stridor secondary to prolonged 
laryngospasm in a patient with Parkinson's disease, and (2) to review the 
literature on stridor in Parkinson's disease.
METHODS: We report a 73-year-old Parkinson's disease patient who developed acute 
stridor due to prolonged laryngospasm triggered by overspill of excessive 
secretions. The literature was reviewed, following a Medline search using the 
keywords 'Parkinson's disease' and 'stridor' or 'airway obstruction' or 
'laryngospasm' or 'laryngeal dystonia' or 'bilateral vocal cord palsy'.
RESULT: Only 12 previously reported cases of stridor in Parkinson's disease 
patients were identified. Causes included bilateral vocal fold palsy (eight 
cases), laryngospasm (five), and dystonia of the jaw and neck muscles (two). The 
mechanism of laryngospasm in our patient was similar to 'dry drowning', and has 
not previously been described.
CONCLUSION: Laryngospasm can be triggered in Parkinson's disease by excessive 
secretions entering the larynx. The mechanism is similar to 'dry drowning'. 
Treatment focuses on reducing secretions. The use of botulinum toxin to reduce 
spasm is inappropriate in this situation. This case emphasises the importance of 
recognising different causes of stridor in Parkinson's disease patients, as this 
affects management.