Diagnosis and Management of Psychogenic Stridor Caused by a Conversion Disorder

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Abstract
Psychogenic stridor, a recently reported cause of acute upper-airway obstruction, is also known as paradoxical vocal cord motion.1-3 Although reported to occur predominantly among young women,1,2 it has been recognized in both male adolescents and adults,3 as well as in older women.4,5 Several authors1,3,4,6 have associated psychogenic stridor with conversion disorder, but few have included a discussion of the diagnostic criteria or elaborated on the underlying mechanisms of the conversion process. In the case of a female adolescent with a diagnosis of paradoxical vocal cord motion presented here, we have included a discussion of the diagnostic psychological criteria. We also present the combined psychophysiological approach we used to identify and release the underlying affect, which resulted in the complete, immediate, and to date, lasting remittance of our patient's symptoms.

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