Psychogenic stridor

In the past 20 years, several cases have been reported describing an upper airway obstruction reportedly caused by psychological factors. This paper reviews 48 reported cases of "psychogenic stridor." Patients with psychogenic stridor usually present to primary care physicians with symptoms of asthma or stridor unresponsive to conventional treatments. Of the 48 cases reviewed, 52% received a diagnosis of conversion disorder. The obstruction was severe enough to cause intubation and tracheostomies in some patients. In addition, many suffered from the unnecessary side effects of corticosteroids. The literature is reviewed and medical and psychiatric differential diagnosis and treatment are discussed.