We report a 63-year-old patient with lateral medullary syndrome secondary to a medullary haemorrhage, causing unilateral vocal cord palsy which precipitated respiratory failure sufficient to warrant intubation and ventilation. The patient recovered completely following neurological rehabilitation and was discharged home a month later. Centrally-mediated vocal cord palsy is a rare cause of stridor, but should be suspected in cases where no other local cause can be found.
